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Parente H, Pontes Ferreira M, Soares C, Guimarães F, Azevedo S, Santos-Faria D, Tavares-Costa J, Peixoto D, Afonso C, Roriz D, Teixeira F. Lumbosacral pain in a patient with psoriatic arthritis: when the rheumatic disease is innocent. Reumatismo 2023; 75. [PMID: 38115779 DOI: 10.4081/reumatismo.2023.1565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 08/30/2023] [Indexed: 12/21/2023] Open
Abstract
Lumbar pain is a very common symptom that derives from benign musculoskeletal conditions, rheumatic inflammatory diseases, neoplasms, and referred and/or nociplastic pain. A 70-year-old man with psoriatic arthritis presented with early-onset lumbosacral pain without evident red flags. Symptomatic treatment was unhelpful. Radiographic imaging showed subtle signs of a disease that could easily be missed. Magnetic resonance imaging revealed a massive prostatic malignancy with bone (sacral and iliopubic) metastasis. Awareness must be given not to disregard every lumbar pain as part of the preexisting rheumatic inflammatory disease (spondyloarthropathy in this case) or a common muscle/ligament/articular disarrangement. Persistence of pain, albeit not inflam-matory nor sharp in nature, despite adequate treatment might be just as important as an acute red flag and requires proper follow-up.
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Affiliation(s)
- H Parente
- Department of Rheumatology, Unidade Local de Saúde do Alto Minho, Ponte de Lima.
| | - M Pontes Ferreira
- Department of Rheumatology, Unidade Local de Saúde do Alto Minho, Ponte de Lima.
| | - C Soares
- Department of Rheumatology, Unidade Local de Saúde do Alto Minho, Ponte de Lima.
| | - F Guimarães
- Department of Rheumatology, Unidade Local de Saúde do Alto Minho, Ponte de Lima.
| | - S Azevedo
- Department of Rheumatology, Unidade Local de Saúde do Alto Minho, Ponte de Lima.
| | - D Santos-Faria
- Department of Rheumatology, Unidade Local de Saúde do Alto Minho, Ponte de Lima.
| | - J Tavares-Costa
- Department of Rheumatology, Unidade Local de Saúde do Alto Minho, Ponte de Lima.
| | - D Peixoto
- Department of Rheumatology, Unidade Local de Saúde do Alto Minho, Ponte de Lima.
| | - C Afonso
- Department of Rheumatology, Unidade Local de Saúde do Alto Minho, Ponte de Lima.
| | - D Roriz
- Department of Radiology, Unidade Local de Saúde do Alto Minho, Viana do Castelo.
| | - F Teixeira
- Department of Rheumatology, Unidade Local de Saúde do Alto Minho, Ponte de Lima.
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Temtem M, Mendonca MI, Serrao M, Santos M, Sa D, Soares C, Sousa AC, Henriques E, Rodrigues M, Freitas S, Borges S, Ornelas I, Drumond A, Palma Dos Reis R. Prognostic impact of adding Coronary Calcium Score to European SCORE2 in an asymptomatic Portuguese population. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
The new European SCORE2 estimates the combined risk of fatal and non-fatal cardiovascular (CV) events, in contrast with SCORE's use for CV mortality only. Although controversial, several studies point out that Coronary Artery Calcification (CAC) scoring could improve CV risk stratification in primary prevention.
Purpose
Assess the impact of including CAC score to the new SCORE2 in MACE prediction and CV risk stratification in an asymptomatic Portuguese population.
Methods
The new SCORE2 was calculated in a population-based cohort of 1,014 individuals (mean age 58.6±8.5 years) without known CV disease and diabetes. Population was stratified into three SCORE2 risk categories (low-, moderate- and high-risk). According to the Hoff's nomogram, CAC score was categorized into: low CAC (0≤CAC<100 or P<50); moderate CAC (100≤CAC<400 or P50–75) and high or severe CAC (CAC≥400 or P>75). Kaplan-Meier survival curves were estimated and a multivariate regression analysis predicted the MACE risk for both scores. C-statistic methodology evaluated the ability of CAC when added to the SCORE2 model in MACE prediction.
Results
Kaplan-Meier curves showed that the highest categories of both scores presented a worst survival. Cox regression analysis showed that the highest categories of both CAC and SCORE2 remained in the equation with an increased MACE risk (HR) of 3.69 (p=0.008) and 9.87 (p=0.005), respectively, when compared with the lowest categories. C-statistic demonstrated that the predictive value for MACE increased from 0.668 (SCORE2 model) to 0.787 when CAC was included (p=0.012), showing a better predictive and discriminative capacity for MACE.
Conclusions
Our results highlight the importance of adding CAC score to SCORE2 in primary prevention to improve cardiovascular risk stratification and MACE risk prediction. Larger prospective multicenter cohorts with longer follow-up should reproduce and validate these findings.
Funding Acknowledgement
Type of funding sources: Public hospital(s). Main funding source(s): SESARAM EPERAM
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Affiliation(s)
- M Temtem
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - M I Mendonca
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - M Serrao
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - M Santos
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - D Sa
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - C Soares
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - A C Sousa
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - E Henriques
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - M Rodrigues
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - S Freitas
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - S Borges
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - I Ornelas
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - A Drumond
- Hospital Funchal , Funchal , Portugal
| | - R Palma Dos Reis
- New University of Lisbon, Faculty of Medical Sciences , Lisbon , Portugal
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Temtem M, Palma Dos Reis R, Serrao M, Sa D, Santos M, Soares C, Sousa AC, Rodrigues M, Freitas S, Henriques E, Borges S, Guerra G, Ornelas I, Drumond A, Mendonca MI. Prognostic role of adding a genetic risk score to the new European SCORE2 in a cardiovascular events prediction, in a moderate-risk region. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
The new SCORE2 provides risk estimates for the combined outcome of fatal and non-fatal cardiovascular disease (CVD) events, in contrast with SCORE's use for CVD mortality only. Genetic predisposition to CVD is not considered in SCORE2 for prevention and treatment.
Purpose
Evaluate the impact of adding a Genetic Risk Score (GRS) to the new European SCORE2 in MACE prediction and estimate the additional value in cardiovascular risk stratification in an asymptomatic Portuguese population.
Methods
A prospective study was performed in a population-based cohort of 1,100 individuals without known CVD and diabetes (mean age 53.3±6.9 years). For all included participants, SCORE2 was calculated and three risk categories were considered: low-, moderate- and high-risk. A 33-SNP GRS was constructed and two groups were analyzed: lower and higher than the GRS median. Kaplan-Meier survival curves were created and a Cox regression model was performed with the two scores to assess MACE risk. C-statistic methodology compared the model between SCORE2 solely and SCORE2 plus GRS.
Results
After Kaplan-Meier analysis for MACE occurrence, the high categories of SCORE 2 and GRS showed worst survival when compared to the lower categories (p<0.0001). Cox regression presented an HR of 8.528 (p=0.001) for high-risk SCORE2 and an HR of 4.520 (p<0.0001) for GRS higher than the median. C-statistic demonstrated that the SCORE2 predictive value was 0.678, increasing to 0.792 when GRS was included (p=0.0005).
Conclusions
In this work, combining SCORE2 with multiple genetic loci gathered into a GRS, improved the identification of patients with the worst prognosis. This new tool may be of great utility in risk stratification in primary prevention. Larger prospective multicenter cohorts with longer follow-up should reproduce and validate these findings.
Funding Acknowledgement
Type of funding sources: Public hospital(s). Main funding source(s): SESARAM EPERAM
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Affiliation(s)
- M Temtem
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - R Palma Dos Reis
- New University of Lisbon, Faculty of Medical Sciences , Lisbon , Portugal
| | - M Serrao
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - D Sa
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - M Santos
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - C Soares
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - A C Sousa
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - M Rodrigues
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - S Freitas
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - E Henriques
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - S Borges
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - G Guerra
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - I Ornelas
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - A Drumond
- Hospital Funchal , Funchal , Portugal
| | - M I Mendonca
- Funchal Hospital, Research Unit , Funchal , Portugal
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Deon B, Cotta K, Silva R, Batista C, Justino G, Freitas G, Cordeiro A, Barbosa A, Loução F, Simioni T, Morais A, Medeiros I, Almeida R, Araújo C, Soares C, Padoin N. Digital twin and machine learning for decision support in thermal power plant with combustion engines. Knowl Based Syst 2022. [DOI: 10.1016/j.knosys.2022.109578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Simas J, Delgado A, Guedes R, Silveira C, Soares C. Management of Parkinson’s disease challenged by co-morbid drug abuse. Eur Psychiatry 2022. [PMCID: PMC9566004 DOI: 10.1192/j.eurpsy.2022.1188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Parkinson’s disease (PD) is a neurologic degenerative condition with complex neuropsychiatric manifestations which can be challenging to manage and greatly impact quality of life and prognosis. Objectives The description of this case aims to highlight the complex interaction between PD, drug-abuse and impulse control disorder (ICD). Methods Clinical information was obtained through patient interviewing and medical records consulting. A literature review on the topic was conducted. Results We report the case of a 52-years-old male with PD diagnosed at the age of 45, presenting with rigidity of right limbs and freezing of gait. He had a history of multiple substance-abuse: hashish, heroin and cocaine, with cessation of all substances by the age of 40. The patient responded well to antiparkinsonian medication initially, but needed frequent adjustments and developed ICD secondary to dopamine agonists, presenting pathological gambling and hypersexuality. At 47 he restarted using cocaine stating that it diminished the motor symptoms. Motor symptoms worsened and became partially responsive to medication. Pharmacologic options were limited due to ICD. He developed dopamine dysregulation syndrome, abusing dopaminergic drugs and requesting multiple prescriptions. Deep brain stimulation surgery was proposed, but the patient was deemed unfit for the procedure after two separate psychiatric evaluations, mainly because of behaviour and social problems in relation to sustained cocaine abuse and personality disorder. Attempts to stop drug abuse were unsuccessful despite several interventions by addiction psychiatry. Conclusions Co-occurrence of PD, substance-abuse and personality disorder poses as a therapeutic challenge conditioned by pharmacological iatrogenesis and behavioural disturbances, requiring a multidisciplinary and individualized approach. Disclosure No significant relationships.
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Nogueira M, Melo C, Grangeia A, Magalhães T, Soares C, Dias R, Fonseca J, Sampaio M, Sousa R. PURA syndrome in a child with severe developmental delay: a challenging diagnosis. Rev Neurol 2022; 74:170-173. [PMID: 35211951 DOI: 10.33588/rn.7405.2021068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
INTRODUCTION PURA syndrome is a rare autosomal dominant condition caused by de novo pathogenic variants in PURA gene and characterized by a multisystemic phenotype that includes global neurodevelopmental delay, early hypotonia, absence of speech, feeding difficulties, hypersomnolence, epilepsy and movement disorders. CASE REPORT We report a 9-year-old girl with hypotonia and feeding difficulties with failure to thrive since the neonatal period. At the age of 3 years motor and intellectual delay were evident, she had a wide-based gait, no speech and an exaggerated acoustic startle response. She developed hand-mouthing stereotypies and epilepsy at 6 years old. The 24 hours continuous electroencephalogram monitoring revealed global slow activity and frequent epileptiform activity in left temporal and centrotemporal areas. The brain MRI revealed delayed myelination. At 6 years old the clinical exome sequencing identified a heterozygous pathogenic variant in the PURA gene, c.153delA p.(Leu54CysfsTer24). CONCLUSION PURA syndrome has clinical features similar to other neurological disorders but the association with some clinical features, not as common in other neurological entities, like never being able to speak but being able to follow simple orders and exaggerated acoustic startle response, should raise the suspicion of PURA syndrome and genetic analysis must be performed to confirm the diagnosis and provide early multidisciplinary intervention.
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Affiliation(s)
- M Nogueira
- Centro Hospitalar Universitário de São João, Oporto, Portugal
| | - C Melo
- Centro Hospitalar Universitário de São João, Oporto, Portugal
| | - A Grangeia
- Centro Hospitalar Universitário de São João, Oporto, Portugal
| | - T Magalhães
- Centro Hospitalar Universitário de São João, Oporto, Portugal
| | - C Soares
- Centro Hospitalar Universitário de São João, Oporto, Portugal
| | - R Dias
- Centro Hospitalar Universitário de São João, Oporto, Portugal
| | - J Fonseca
- Centro Hospitalar Universitário de São João, Oporto, Portugal
| | - M Sampaio
- Centro Hospitalar Universitário de São João, Oporto, Portugal
| | - R Sousa
- Centro Hospitalar Universitário de São João, Oporto, Portugal
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Barros T, Soares C, Andrade A, Moreira C, Guedes-Martins L, Braga J. 213 Case report: fetal malformations and 3P22.2P21.2 Deletion. Eur J Obstet Gynecol Reprod Biol 2022. [DOI: 10.1016/j.ejogrb.2021.11.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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8
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Cardoso F, Costa F, Soares C, de Moraes M, D’alva C, Cavalcante DS, Cid A, Ribeiro T, Quidute A. Oral health aspects in sporadic and familial primary hyperparathyroidism. J Clin Exp Dent 2022; 14:e396-e403. [PMID: 35582348 PMCID: PMC9094720 DOI: 10.4317/jced.59527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 03/28/2022] [Indexed: 11/05/2022] Open
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9
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Amado A, Castro B, Torre AP, Graça S, Tavares A, Póvoa A, Soares C, Gonçalves G. Serum TSH as a predictor of malignancy in indeterminate thyroid nodules. Ann R Coll Surg Engl 2021; 104:380-384. [PMID: 34939834 DOI: 10.1308/rcsann.2021.0196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Thyroid nodules are lesions that are radiologically distinct from the thyroid parenchyma. Cervical ultrasound diagnoses 19-67% of nodules and is crucial in identifying those that lack cytological characterisation. Approximately 25% of biopsies reveal an indeterminate cytological result (Bethesda III), in which the risk of malignancy is variable (5-15%). The clinical importance of the diagnostic strategy used for thyroid nodules results from the need to exclude malignancy. The aim of this study was to evaluate the usefulness of serum thyroid-stimulating hormone (TSH) levels as a predictor of malignancy in cytologically indeterminate thyroid nodules. METHODS Our retrospective study included 40 patients with cytologically indeterminate thyroid nodules seen in our hospital between January 2013 and December 2017. Clinical parameters were reviewed, including age, gender, serum TSH levels, family history of thyroid carcinoma, radiation exposure and some sonographic features of the nodules. Statistical analysis was performed using SPSS. Statistical significance was defined as p<0.05. RESULTS Female gender was predominant (85%) and the mean (SD) age was 53.3 (15) years. Thyroid carcinoma was confirmed in 28% of patients. Median TSH levels were higher in patients with malignant (2.73µIU/ml) compared with benign (1.56µIU/ml) nodules (p<0.05). We demonstrated an increased risk of malignancy in patients with TSH levels of 2.68µIU/ml or above (p<0.05). CONCLUSION Higher serum TSH levels are associated with an increased risk of thyroid carcinoma in cytologically indeterminate nodules. TSH can become a fundamental diagnostic tool in stratifying the risk of malignancy and assist in diagnostic and therapeutic approaches to these nodules.
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Affiliation(s)
- A Amado
- Vila Nova de Gaia/Espinho Hospital Center (CHVNG/E), Vila Nova de Gaia, Portugal
| | - B Castro
- Vila Nova de Gaia/Espinho Hospital Center (CHVNG/E), Vila Nova de Gaia, Portugal
| | - A P Torre
- Vila Nova de Gaia/Espinho Hospital Center (CHVNG/E), Vila Nova de Gaia, Portugal
| | - S Graça
- Vila Nova de Gaia/Espinho Hospital Center (CHVNG/E), Vila Nova de Gaia, Portugal
| | - A Tavares
- Vila Nova de Gaia/Espinho Hospital Center (CHVNG/E), Vila Nova de Gaia, Portugal
| | - A Póvoa
- Vila Nova de Gaia/Espinho Hospital Center (CHVNG/E), Vila Nova de Gaia, Portugal
| | - C Soares
- Vila Nova de Gaia/Espinho Hospital Center (CHVNG/E), Vila Nova de Gaia, Portugal
| | - G Gonçalves
- Vila Nova de Gaia/Espinho Hospital Center (CHVNG/E), Vila Nova de Gaia, Portugal
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Temtem M, Mendonca MI, Soares C, Serrao M, Rodrigues R, Santos M, Sousa JA, Mendonca F, Sousa AC, Rodrigues M, Henriques E, Freitas S, Drumond A, Palma Dos Reis R. Does coronary calcium score add value to European SCORE in an asymptomatic population? Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Despite being a controversial subject, multiple guidelines mention the use of Coronary Artery Calcification (CAC) scoring in the cardiovascular risk prediction in the asymptomatic population. Adding CAC score to European SCORE (Systematic Coronary Risk Evaluation) may improve the prediction of MACE (Major Adverse Cardiovascular Events), providing better cardiovascular risk stratification.
Purpose
Our study aims to evaluate the impact of CAC severity in MACE prediction compared with SCORE and estimate the additional value of CAC score in cardiovascular risk stratification in a low- risk region and asymptomatic population.
Methods and results
The study consisted of a prospective registry of 1110 asymptomatic individuals free of known coronary heart disease, enrolled from the GENEMACOR study and referred for computed tomography for the CAC scoring assessment. The mean age was 51.6±8.2 years, and 74.1% were male. This population was followed for a mean of 5.2±3.3 years for the primary endpoint of all-cause of cardiovascular events. The extent of CAC differs significantly between men and women in the same age group. Therefore, the distribution of CAC score by age and gender was done using Hoff's nomogram (a). According to this nomogram, 3 categories were created: low CAC (0≤CAC<100 and P<50); moderate CAC (100≤CAC<400 or P50–75) and high CAC (CAC≥400 or P>75). Through a Cox regression for MACE occurrence, SCORE does not remain in the equation, and the higher severity level of CAC presented a significant risk of MACE occurrence with an HR of 7.943 (95% CI 2.948 – 21.401; p<0.0001). Using the C-index, CAC was superior to SCORE (0.729 vs 0.615; p<0.0001). Adding CAC score to SCORE increased MACE prediction compared to SCORE alone (AUC 0.77 vs 0.615; p=0.003).
Conclusion
Our results point to the importance of the CAC score inclusion in primary prevention to improve cardiovascular risk stratification. CAC score in clinical practice could have a prognostic impact on MACE prediction. Larger prospective multicenter cohorts with longer follow-up should reproduce and validate these findings.
Funding Acknowledgement
Type of funding sources: None. Table 1
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Affiliation(s)
- M Temtem
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - M I Mendonca
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - C Soares
- Hospital Dr. Nelio Mendonca, Funchal, Portugal
| | - M Serrao
- Hospital Dr. Nelio Mendonca, Funchal, Portugal
| | - R Rodrigues
- Hospital Dr. Nelio Mendonca, Funchal, Portugal
| | - M Santos
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - J A Sousa
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - F Mendonca
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - A C Sousa
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - M Rodrigues
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - E Henriques
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - S Freitas
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - A Drumond
- Hospital Dr. Nelio Mendonca, Funchal, Portugal
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Soares C, Temtem M, Mendonca MI, Sousa JA, Santos M, Sousa AC, Rodrigues M, Henriques E, Freitas S, Borges S, Guerra G, Drumond A, Palma Dos Reis R. Comparison between a genetic risk score and the European SCORE in cardiovascular events prediction in a primary prevention population. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
The risk for Coronary Artery Disease (CAD) can be estimated using different scores, such as the European SCORE (Systematic Coronary Risk Evaluation) scale or genetic risk score (GRS). The addition of GRS to the European SCORE may increase the precision of predicting MACE (Major Adverse Cardiovascular Events).
Purpose
This study aims to compare the European SCORE and the multiplicative genetic risk score (mGRS) in predicting MACE.
Methods and results
The study included 1110 asymptomatic individuals without known CAD from GENEMACOR prospective registry. We defined the primary endpoint of all-cause cardiovascular events.
The study population had mean age of 51.6 years, 74.1% male and had risk factors of diabetes (11.6%), dyslipidemia (67.5%), hypertension (48.1%) and smoking (22.9%). Using C-index methodology, mGRS score was superior to SCORE in predicting MACE (mGRS = 0.832 Vs SCORE = 0.615; p=0.014).
Conclusions
The mGRS score was superior to SCORE in predicting MACE in an asymptomatic and free of CAD population. Genetic information may improve cardiovascular risk stratification in primary prevention.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- C Soares
- Hospital Dr. Nelio Mendonca, Funchal, Portugal
| | - M Temtem
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - M I Mendonca
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - J A Sousa
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - M Santos
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - A C Sousa
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - M Rodrigues
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - E Henriques
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - S Freitas
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - S Borges
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - G Guerra
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - A Drumond
- Hospital Dr. Nelio Mendonca, Funchal, Portugal
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Soares C, Grazina A, Vaz C, Henriques P, Correia G, Nunes R, Pereira A, Mykhayliv V, Sousa M, Spencer C. IRRADIATED BLOOD PRODUCTS-INSTITUTE PORTUGUESE OF ONCOLOGY – COIMBRA (IPOC) – EXPERIENCE OF BLOOD QUALITY ASSURANCE. Hematol Transfus Cell Ther 2021. [DOI: 10.1016/j.htct.2021.10.680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Nunes R, Correia G, Soares C, Vaz C, Pereira A, Henriques P, Grazina A, Mykhayliv V, Spencer C. EVALUATION OF BLOOD HEMOLYSIS IN ERYTHROCYTES CONCENTRATE: OUR EXPERIENCE-INSTITUTE OF ONCOLOGY COIMBRA (IPOC). Hematol Transfus Cell Ther 2021. [DOI: 10.1016/j.htct.2021.10.621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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14
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Ferreira V, Almeida Morais L, Sousa L, Fiarresga A, Martins J, Timoteo A, Viveiros Monteiro A, Loureiro P, Soares C, Castelo A, Garcia Bras P, Reis J, Pinto F, Agapito A, Cruz Ferreira R. New onset atrial fibrillation after percutaneous Patent Foramen Ovale closure: how serious is this problem? Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Percutaneous Patent Foramen Ovale (pPFO) closure benefits for secondary prevention after cardio-embolic stroke have recently been proved. With the increasing number of cases and procedures, a concern with new onset atrial fibrillation (NOAF) has been raised.
Purpose
To evaluate long-term outcome regarding NOAF rate and to identify its predictors and clinical impact, in a real population submitted to pPFO closure.
Methods
From 2000 to 2017, consecutive patients (P) submitted to pPFO closure in a tertiary centre were prospectively enrolled. The primary endpoint was NOAF rate and secondary endpoints were all-cause, neurologic and cardiac mortality rates and recurrent ischemic events. Previous and follow-up electrocardiographic, echocardiographic and 24-hour heart rhythm monitoring data were analysed. Follow-up was performed through medical visits, medical charts consultation and a phone call based system, in order to assess clinical status, on-going treatment and events.
Results
496 patients were submitted to pPFO. Immediate success was achieved in 98.8% and 9.1% presented a residual shunt on the 1st year TEE. Mean age was 45.0±11.2 years-old with 50.2% of males. The prevalence of hypertension, hypercholesterolemia and atrial septum aneurysm (ASA) was 25.7%, 45.0% and 46.3%, respectively. Pre-procedural mean left atrial (LA) diameter was 36.0±5.3 mm. FU data was available for 490 (98.6%), for a mean FU time of 7.41±3.51 years. 34 P (6.9%) presented ischemic events recurrence (26 strokes and 8 TIA). The primary endpoint was observed in 21 P (4.3%) during the FU period.
Median time to 1st AF episode since PFO closure was 5.90±5.53 years. 11 P (52.3%) initiated oral anticoagulation. In univariate analysis, age (44.6±11.3 vs 51.8±6.0 years, p=0.005) and hypertension (24.7% vs 47.6%, p=0.019) were predictors of NOAF in this population. In multivariated analysis, only age remained a predictor of NOAF (OR 1.05 (1.007–1.101), p=0.025). LA pre pPFO closure dimensions, ASA, device type or size and the presence of residual shunt in TEE were not determinants of AF occurrence. The incidence of NOAF was associated with the need for hospitalization due to cardiac causes (19% vs 3.2%, p=0.001) and a trend towards higher rate of recurrent stroke (4.9% vs 14.3%, p=0.06).
Conclusion
Despite being a highly successful and safe procedure in most patients, pPFO closure was associated with a non-negligenciable rate of NOAF during long-term follow-up. NOAF predictors were related with classical cardiovascular risk factors, such as age and hypertension. None of the procedure or device features were associated with NOAF. Yet, a clinical impact was attributed to NOAF, with more hospitalizations and a trend towards ischemic events recurrence.
As young patients submitted to pPFO closure grow older, prevention strategies to diagnose and treat NOAF should be endeavoured.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- V Ferreira
- Hospital de Santa Marta, Lisbon, Portugal
| | | | - L Sousa
- Hospital de Santa Marta, Lisbon, Portugal
| | | | | | | | | | - P Loureiro
- Hospital de Santa Marta, Lisbon, Portugal
| | - C Soares
- Hospital de Santa Marta, Lisbon, Portugal
| | - A Castelo
- Hospital de Santa Marta, Lisbon, Portugal
| | | | - J Reis
- Hospital de Santa Marta, Lisbon, Portugal
| | - F Pinto
- Hospital de Santa Marta, Lisbon, Portugal
| | - A Agapito
- Hospital de Santa Marta, Lisbon, Portugal
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Soares C, Ferreira D, Araújo R. Gender analysis of 'man-in-the-barrel' syndrome: is 'person-in-the-barrel' a more adequate term? Eur J Neurol 2020; 28:341-343. [PMID: 32961582 DOI: 10.1111/ene.14551] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 09/15/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND PURPOSE Gender bias is a known issue in healthcare and academia. We analysed the gender of patients reported in the literature with 'man-in-the-barrel' syndrome or equivalent semiological terms. METHODS A search in the PubMed database was conducted using the terms 'man-in-the-barrel', 'person-in-the-barrel', 'woman-in-the-barrel', 'brachial diplegia', 'flail arm' and 'cruciate paralysis'. All articles published between 1969 and 2020 containing a detailed description compatible with the original description of man-in-the-barrel syndrome were included. RESULTS Ninety-five patients with a clinical picture compatible with man-in-the-barrel syndrome were included. Up to 33% of patients were female. Overall, the proportion of female patients with man-in-the-barrel syndrome was 25%. DISCUSSION AND CONCLUSIONS The term man-in-the-barrel may disenfranchise up to a third of women presenting with brachial diplegia with undesirable consequences. We propose a gender-neutral alternative such as 'person-in-the-barrel'.
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Affiliation(s)
- C Soares
- Department of Neurology, Centro Hospitalar Universitário São João, EPE, Porto, Portugal.,Department of Clinic Neurosciences and Mental Health, Faculty of Medicine of University of Porto, Porto, Portugal
| | - D Ferreira
- Department of Neurology, Centro Hospitalar Universitário São João, EPE, Porto, Portugal.,Department of Clinic Neurosciences and Mental Health, Faculty of Medicine of University of Porto, Porto, Portugal
| | - R Araújo
- Department of Neurology, Centro Hospitalar Universitário São João, EPE, Porto, Portugal.,Department of Clinic Neurosciences and Mental Health, Faculty of Medicine of University of Porto, Porto, Portugal
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Soares C, Tenreiro Machado JA, Lopes AM, Vieira E, Delerue-Matos C. Electrochemical impedance spectroscopy characterization of beverages. Food Chem 2020; 302:125345. [PMID: 31445377 DOI: 10.1016/j.foodchem.2019.125345] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Revised: 08/07/2019] [Accepted: 08/07/2019] [Indexed: 10/26/2022]
Abstract
This paper compares the results of standard chemical analytical processes and electrochemical impedance spectroscopy (EIS) in the characterization of different beverages, namely ground coffee, soluble coffee, coffee substitutes, barley, cow milk, vegetable drinks, tea, plant infusions and plant mixtures. For the two approaches, the similarities between the experimental data are assessed by means of the Euclidean and Canberra distances. The resulting information is processed by means of the multidimensional scaling (MDS) clustering and visualization algorithm. The results of the chemical analytical processes and EIS reveal identical clusters for the two adopted distances. Furthermore, the robustness of the experimental and computational scheme are assessed by means of the Procrustes technique. The results confirm the effectiveness of combining the EIS and MDS.
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Affiliation(s)
- C Soares
- REQUIMTE/LAQV, Institute of Engineering, Polytechnic of Porto, R. Dr. António Bernardino de Almeida, 431, 4249 - 015 Porto, Portugal.
| | - J A Tenreiro Machado
- Institute of Engineering, Polytechnic of Porto, Dept. of Electrical Engineering, R. Dr. António Bernardino de Almeida, 431, 4249 - 015 Porto, Portugal.
| | - António M Lopes
- UISPA-LAETA/INEGI, Faculty of Engineering, University of Porto, Rua Dr. Roberto Frias, 4200 - 465 Porto, Portugal.
| | - E Vieira
- REQUIMTE/LAQV, Institute of Engineering, Polytechnic of Porto, R. Dr. António Bernardino de Almeida, 431, 4249 - 015 Porto, Portugal.
| | - C Delerue-Matos
- REQUIMTE/LAQV, Institute of Engineering, Polytechnic of Porto, R. Dr. António Bernardino de Almeida, 431, 4249 - 015 Porto, Portugal.
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17
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Soares C, Pacheco A, Zabel F, González-Goberña E, Sequeira C. Baseline assessment of underwater noise in the Ria Formosa. Mar Pollut Bull 2020; 150:110731. [PMID: 31753564 DOI: 10.1016/j.marpolbul.2019.110731] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2019] [Revised: 11/06/2019] [Accepted: 11/11/2019] [Indexed: 06/10/2023]
Abstract
The Ria Formosa is a sheltered large coastal lagoon located on the Atlantic South Coast of Portugal, that has been classified as a natural park since 1987. The lagoon hosts a diverse and abundant fish community and other species of commercial importance. Several economical activities are supported by shipping, and as such, vessel traffic within the Ria Formosa lagoon is very intense at some locations during particular seasons of the year, creating high levels of underwater noise. Recently, strong efforts are being made to turn the main inlet of the lagoon, the Faro-Olhão Inlet, a testing site for small scale tidal stream turbines, which will bring an additional source of underwater noise. Underwater noise can be one of a number of factors causing habitat degradation, as it can perturb fish behavior and cause physiological damage. Therefore, in order to comply with underwater noise pollution regulations, tidal energy technology developers are very interested in minimising the introduction of acoustic energy in the environment during the operation of their devices. Under the scope of project SCORE, which involved the deployment and operation of a floating tidal energy converter, this paper presents and discusses the first baseline noise monitoring performed at Ria Formosa. The acoustic data were collected in two occasions over several days, one in the winter and the other in the summer, in 2017. The obtained analysis results highlight the potential impact of the intense boat traffic in Ria Formosa, and the wide range of sound levels introduced in that ecosystem, and the high diurnal and seasonal variability.
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Affiliation(s)
- C Soares
- MarSensing Lda., Centro Empresarial Pavilhão B1, Campus de Gambelas, 8005-139 Faro, Portugal.
| | - A Pacheco
- CIMA, University of Algarve Ed7, Campus de Gambelas, Faro 8005-139, Portugal
| | - F Zabel
- MarSensing Lda., Centro Empresarial Pavilhão B1, Campus de Gambelas, 8005-139 Faro, Portugal
| | - E González-Goberña
- CIMA, University of Algarve Ed7, Campus de Gambelas, Faro 8005-139, Portugal
| | - C Sequeira
- CIMA, University of Algarve Ed7, Campus de Gambelas, Faro 8005-139, Portugal
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Timoteo AT, Gouveia M, Soares C, Ferreira RC. P5243Indirect costs of acute myocardial infarction in Portugal. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Cardiovascular diseases are the main cause of death in Portugal. The high incidence of acute myocardial infarction (AMI) is also a major problem, particularly due to the economic burden caused by productivity losses (indirect costs) associated with temporary absence from work, not yet sufficiently studied in Portugal. Our objective was to quantify the indirect costs of AMI in the first year after admission.
Methods
All consecutive patients admitted in a single center with <66 years (official retirement age) during one year that survived to discharge were included in the present study. Employment status on admission was assessed in every patient. For each employed patient, working at the time of admission, the monthly wage was estimated from market wage rates from national public sources (grossed up by social security contributions) according to gender and age. A day-cost was calculated to assess the cost of temporary absence from work. A half-day absence was considered for Cardiology medical appointments and exams. The duration of temporary absence from work was assessed by a first follow-up contact at 30-day and a second follow-up evaluation up to one-year after admission. The cost of temporary absence from work per episode was calculated in this sample and results were applied to the total number of MI in Portugal during the year 2016 (last available national data) and separately according to ST-elevation AMI (STEAMI) or non-ST-elevation acute coronary syndrome (NSTACS).
Results
We included 219 patients (54±7 years, 83% males), from which, 66.2% were working, 16.4% early-retired, 11.9% unemployed and 5.5% in long-term exit from work due to non-cardiac disease. During the one-year follow-up there were no changes in employment status. In our sample, mean monthly labor cost was 1802 euros (69 euros/day). Median number of days absent from work were 34 days (31 days in men and 52 days in women) and a median of 2 half-days were also obtained for Cardiology appointments / exams. We obtained a total cost of 760.521,55 euros. We used available data from 2016 to estimate indirect costs at a national level. There were 4133 patients with <66 years admitted in Portugal due to AMI that survived to discharge. We performed an analysis, using the proportions of 41% of cases with STEAMI and 59% with NSTACS that came out of the Portuguese Registry on Acute Coronary Syndromes and the working patient's proportions in each group. Costs were higher in patients with STEAMI. We estimate an indirect total cost in Portugal of € 10.12 million in the first year after MI.
Conclusions
In Portugal, the costs to society of disability generated losses of productivity are over ten million euros during the first year after AMI. Strategies to improve time of return to work are very important to lower these costs.
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Affiliation(s)
- A T Timoteo
- Hospital Santa Marta, CHLC, Lisbon, Portugal
| | - M Gouveia
- Hospital Santa Marta, CHLC, Lisbon, Portugal
| | - C Soares
- Hospital Santa Marta, CHLC, Lisbon, Portugal
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19
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Melo M, Rocha Júnior V, Pimentel P, Caldeira L, Ruas J, Chamone J, Silva FVE, Lanna D, Soares C. Composição de ácidos graxos do queijo e leite de vacas alimentadas com casca de banana. ARQ BRAS MED VET ZOO 2018. [DOI: 10.1590/1678-4162-9476] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
RESUMO Objetivou-se avaliar os níveis de casca de banana seca ao sol na dieta de vacas F1 Holandês x Zebu sobre o perfil de ácidos graxos do leite e do queijo minas frescal. Os tratamentos foram constituídos de 0, 15, 30, 45 e 60% de substituição da silagem de sorgo pela casca de banana. O delineamento experimental foi em dois quadrados latinos 5 x 5 simultâneos. As amostras de leite e queijo foram analisadas quanto ao perfil de ácidos graxos por cromatografia gasosa. Observou-se efeito quadrático para o somatório de ácidos graxos poli-insaturados do leite, com valor máximo no nível de 23,54% de substituição. Houve efeito linear decrescente para os ácidos graxos C15:0 iso e C16:0 iso. Os ácidos graxos heneicosanoico, linoleico, linoleico conjugado e araquidônico apresentaram efeito quadrático. Não houve efeito das dietas sobre os ácidos graxos no queijo. A substituição de até 60% da silagem de sorgo por casca de banana na dieta de vacas em lactação pode ser alternativa para produção e processamento do leite, quando se considera a melhora no valor nutricional da fração lipídica do leite e o aumento dos teores de ácido linoleico conjugado.
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Affiliation(s)
- M.T.P. Melo
- Universidade Estadual de Montes Claros, Brazil
| | | | | | | | - J.R.M. Ruas
- Universidade Estadual de Montes Claros, Brazil
| | | | | | | | - C. Soares
- Universidade Estadual de Montes Claros, Brazil
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20
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Almeida Morais L, Pereira-Da-Silva T, Ramos R, Fiarresga A, Sousa L, Carvalho R, Bernardes L, Patricio L, Aguiar-Rosa S, Soares C, Cacela D, Cruz-Ferreira R. P5358Long-term prognostic impact of diabetes mellitus in a real world population following percutaneous coronary intervention with a second-generation drug-eluting stent. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p5358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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21
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Guerreiro R, Ruano C, Soares C, Santos F, Portugal G, Gomes L, Bento A, Costa M, Fernandes R, Cacao R, Ramos R, Ferreira R, Goncalves L, Aguiar J. P871Validation of pre-test probability model of coronary artery disease in the Portuguese population. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.p871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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22
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Piletti R, Bugiereck A, Pereira A, Gussati E, Dal Magro J, Mello J, Dalcanton F, Ternus R, Soares C, Riella H, Fiori M. Microencapsulation of eugenol molecules by β-cyclodextrine as a thermal protection method of antibacterial action. Materials Science and Engineering: C 2017; 75:259-271. [DOI: 10.1016/j.msec.2017.02.075] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 11/30/2016] [Accepted: 02/14/2017] [Indexed: 10/20/2022]
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Silove DM, Tay AK, Steel Z, Tam N, Soares Z, Soares C, Dos Reis N, Alves A, Rees S. Symptoms of post-traumatic stress disorder, severe psychological distress, explosive anger and grief amongst partners of survivors of high levels of trauma in post-conflict Timor-Leste. Psychol Med 2017; 47:149-159. [PMID: 27682000 DOI: 10.1017/s0033291716002233] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Little is known about the mental health of partners of survivors of high levels of trauma in post-conflict countries. METHOD We studied 677 spouse dyads (n = 1354) drawn from a community survey (response 82.4%) in post-conflict Timor-Leste. We used culturally adapted measures of post-traumatic stress disorder (PTSD), psychological distress, explosive anger and grief. RESULTS Latent class analysis identified three classes of couples: class 1, comprising women with higher trauma events (TEs), men with intermediate TEs (19%); class 2, including men with higher TEs, women with lower TEs (23%); and class 3, comprising couples in which men and women had lower TE exposure (58%) (the reference group). Men and women partners of survivors of higher TE exposure (classes 1 and 2) had increased symptoms of explosive anger and grief compared with the reference class (class 3). Women partners of survivors of higher TE exposure (class 2) had a 20-fold increased rate of PTSD symptoms compared with the reference class, a pattern that was not evident for men living with women exposed to higher levels of trauma (class 1). CONCLUSIONS Men and women living with survivors of higher levels of trauma showed an increase in symptoms of grief and explosive anger. The manifold higher rate of PTSD symptoms amongst women living with men exposed to high levels of trauma requires replication. It is important to assess the mental health of partners when treating survivors of high levels of trauma in post-conflict settings.
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Affiliation(s)
- D M Silove
- Academic Mental Health Unit and Ingham Institute,University of New South Wales and South Western Sydney Local Health District,Level 2, Mental Health Centre,Liverpool Hospital,Sydney, NSW 2170,Australia
| | - A K Tay
- Academic Mental Health Unit and Ingham Institute,University of New South Wales and South Western Sydney Local Health District,Level 2, Mental Health Centre,Liverpool Hospital,Sydney, NSW 2170,Australia
| | - Z Steel
- St John of God Richmond Hospital,School of Psychiatry,University of New South Wales,North Richmond,NSW 2754,Australia
| | - N Tam
- Academic Mental Health Unit and Ingham Institute,University of New South Wales and South Western Sydney Local Health District,Level 2, Mental Health Centre,Liverpool Hospital,Sydney, NSW 2170,Australia
| | - Z Soares
- Alola Foundation,Dili, Timor-Leste
| | - C Soares
- Alola Foundation,Dili, Timor-Leste
| | | | - A Alves
- Alola Foundation,Dili, Timor-Leste
| | - S Rees
- Academic Mental Health Unit and Ingham Institute,University of New South Wales and South Western Sydney Local Health District,Level 2, Mental Health Centre,Liverpool Hospital,Sydney, NSW 2170,Australia
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24
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Silove DM, Tay AK, Tol WA, Tam N, Dos Reis N, da Costa Z, Soares C, Rees S. Patterns of separation anxiety symptoms amongst pregnant women in conflict-affected Timor-Leste: Associations with traumatic loss, family conflict, and intimate partner violence. J Affect Disord 2016; 205:292-300. [PMID: 27552593 DOI: 10.1016/j.jad.2016.07.052] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Revised: 06/19/2016] [Accepted: 07/09/2016] [Indexed: 02/05/2023]
Abstract
BACKGROUND Adult separation anxiety (ASA) symptoms are prevalent amongst young women in low and middle-income countries and symptoms may be common in pregnancy. No studies have focused on defining distinctive patterns of ASA symptoms amongst pregnant women in these settings or possible associations with trauma exposure and ongoing stressors. METHODS In a consecutive sample of 1672 women attending antenatal clinics in Dili, Timor-Leste (96% response), we assessed traumatic events of conflict, ongoing adversity, intimate partner violence (IPV), ASA, post-traumatic stress disorder (PTSD) and severe psychological distress. Latent Class Analysis was used to identify classes of women based on their distinctive profiles of ASA symptoms, comparisons then being made with key covariates including trauma domains of conflict, intimate partner violence (IPV) and ongoing stressors. RESULTS LCA yielded three classes, comprising a core ASA (4%), a limited ASA (25%) and a low symptom class (61%). The core ASA class reported exposure to multiple traumatic losses and IPV and showed a pattern of comorbidity with PTSD; the limited ASA class predominantly reported exposure to ongoing stressors and was comorbid with severe psychological distress; the low symptom class reported relatively low levels of exposure to trauma and stressors. LIMITATIONS The study is cross-sectional, cautioning against inferring causal inferences. CONCLUSIONS The core ASA group may be in need of immediate intervention given the high rate of exposure to IPV amongst this class. A larger number of women experiencing a limited array of non-specific ASA symptoms may need assistance to address the immediate stressors of pregnancy.
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Affiliation(s)
- D M Silove
- Psychiatry Research and Teaching Unit, University of New South Wales, Academic Mental Health Unit, Level 2, Mental Health Centre, Liverpool Hospital, Sydney, New South Wales 2170, Australia
| | - A K Tay
- Psychiatry Research and Teaching Unit, University of New South Wales, Academic Mental Health Unit, Level 2, Mental Health Centre, Liverpool Hospital, Sydney, New South Wales 2170, Australia
| | - W A Tol
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA
| | - N Tam
- Psychiatry Research and Teaching Unit, University of New South Wales, Academic Mental Health Unit, Level 2, Mental Health Centre, Liverpool Hospital, Sydney, New South Wales 2170, Australia
| | | | | | - C Soares
- Alola Women's Foundation, Timor-Leste
| | - S Rees
- Psychiatry Research and Teaching Unit, University of New South Wales, Academic Mental Health Unit, Level 2, Mental Health Centre, Liverpool Hospital, Sydney, New South Wales 2170, Australia.
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Soares C, Morales H, Faria J, Figueiredo A, Pedro L, Venâncio A. Inhibitory effect of essential oils on growth and on aflatoxins production by Aspergillus parasiticus. WORLD MYCOTOXIN J 2016. [DOI: 10.3920/wmj2015.1987] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The aim of this work was to assess the inhibitory effect of essential oils on the growth and aflatoxin production of Aspergillus parasiticus, as well as to correlate it with the chemical composition of the essential oils. Essential oils from six aromatic species (Cymbopogon citratus, Eucalyptus globulus, Origanum vulgare, Ruta graveolens, Salvia officinalis, Satureja montana) were characterised by gas chromatography and tested for their inhibitory effect against A. parasiticus strain MUM 92.02. Furthermore, the in vitro inhibitory effects of these essential oils on the production of aflatoxins were evaluated by HPLC. Results showed that all essential oils retarded the time for visible growth. Growth rate was affected differently depending on the essential oil. S. montana essential oil prevented growth in all cases. The essential oil of R. graveolens inhibited most of the aflatoxin production even though growth inhibition was low, while with C. citratus essential oil trace levels of aflatoxins were detected. Essential oils containing carvacrol and/or thymol (S. montana and O. vulgare) have the highest activity against fungal growth, while an essential oil (R. graveolens) containing 2-undecanone and 8-phenyl-2-octanone inhibited the synthesis of aflatoxins. Although the main component of this essential oil was 2-undecanone (91%), when pure 2-undecanone was tested, it did not inhibit aflatoxin production. Inhibition activity is probably due to the recently identified minor compound or to a synergistic effect. Essential oils seem to be a good alternative to fungicides not only because of environmental issues but also because they do not seem to enhance mycotoxin production as it has been reported for some fungicides.
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Affiliation(s)
- C. Soares
- CEB-Centre of Biological Engineering, University of Minho, 4710-057 Braga, Portugal
| | - H. Morales
- CEB-Centre of Biological Engineering, University of Minho, 4710-057 Braga, Portugal
| | - J. Faria
- Centro de Estudos do Ambiente e do Mar Lisboa, Faculdade de Ciências, Universidade de Lisboa, CBV, DBV, 1749-016 Lisboa, Portugal
| | - A.C. Figueiredo
- Centro de Estudos do Ambiente e do Mar Lisboa, Faculdade de Ciências, Universidade de Lisboa, CBV, DBV, 1749-016 Lisboa, Portugal
| | - L.G. Pedro
- Centro de Estudos do Ambiente e do Mar Lisboa, Faculdade de Ciências, Universidade de Lisboa, CBV, DBV, 1749-016 Lisboa, Portugal
| | - A. Venâncio
- CEB-Centre of Biological Engineering, University of Minho, 4710-057 Braga, Portugal
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Viveiros Monteiro A, Ramos R, Fiarresga A, de Sousa L, Cacela D, Patrício L, Bernardes L, Soares C, Cruz Ferreira R. Timing and long-term prognosis of recurrent MI after primary angioplasty : Stent thrombosis vs. non-stent-related reinfarction. Herz 2016; 42:186-193. [PMID: 27363417 DOI: 10.1007/s00059-016-4446-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Revised: 04/30/2016] [Accepted: 05/13/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND In patients recovering from an ST-segment elevation myocardial infarction (STEMI), it is not clear whether the negative impact of stent thrombosis (ST) is different from a non-stent-related recurrent myocardial infarction (NSRMI). This study sought to assess the long-term incidence and prognostic impact of recurrent myocardial infarction (MI) after percutaneous coronary intervention (PCI) for STEMI by comparing outcomes of ST versus NSRMI. PATIENTS AND METHODS From 2001 to 2007, 1025 patients undergoing PCI for STEMI were prospectively followed up. Patients with ST, with NSRMI, and those free from recurrent MI were compared regarding mortality and major adverse cardiac and cerebrovascular events (MACCE). RESULTS Recurrent MI decreased from 37 events per 1000 person/months in the first month to 3.3 events per 1000 person/months after the first year. The cumulative 5‑year incidence of ST and NSRMI was 5.27 % and 13.2 %, respectively. MACCE at 60 months after recurrence were not significantly different for patients with reinfarction but were significantly higher than for patients free from any recurrent MI (both log-rank p < 0.001). However, the cumulative all-cause death rate did not differ between the three groups (27.8 vs. 26.7 vs. 23.0 %). Compared with ST occurring in the first 30 days after PCI for STEMI, early NSRMI was associated with a significantly reduced risk for all-cause death (HR, 0.21; 95 % CI, 0.33-3.30) but this association did not persist for recurrent MIs occurring in the late (HR, 1.05; 95 % CI, 0.33-3.30) or very late follow-up periods. CONCLUSION Although ST was associated with a significant increase in adverse events in the early recovery period, in the long term, MACCE and all-cause mortality rates were comparable to those for NSRMI.
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Affiliation(s)
- A Viveiros Monteiro
- Cardiology Department, Hospital of Santa Marta, Rua de Santa Marta, 1169-1024, Lisbon, Portugal.
| | - R Ramos
- Cardiology Department, Hospital of Santa Marta, Rua de Santa Marta, 1169-1024, Lisbon, Portugal
| | - A Fiarresga
- Cardiology Department, Hospital of Santa Marta, Rua de Santa Marta, 1169-1024, Lisbon, Portugal
| | - L de Sousa
- Cardiology Department, Hospital of Santa Marta, Rua de Santa Marta, 1169-1024, Lisbon, Portugal
| | - D Cacela
- Cardiology Department, Hospital of Santa Marta, Rua de Santa Marta, 1169-1024, Lisbon, Portugal
| | - L Patrício
- Cardiology Department, Hospital of Santa Marta, Rua de Santa Marta, 1169-1024, Lisbon, Portugal
| | - L Bernardes
- Cardiology Department, Hospital of Santa Marta, Rua de Santa Marta, 1169-1024, Lisbon, Portugal
| | - C Soares
- Cardiology Department, Hospital of Santa Marta, Rua de Santa Marta, 1169-1024, Lisbon, Portugal
| | - R Cruz Ferreira
- Cardiology Department, Hospital of Santa Marta, Rua de Santa Marta, 1169-1024, Lisbon, Portugal
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Hansen J, Culberson W, Soares C, DeWerd L. WE-DE-201-05: Evaluation of a Windowless Extrapolation Chamber Design and Monte Carlo Based Corrections for the Calibration of Ophthalmic Applicators. Med Phys 2016. [DOI: 10.1118/1.4957810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Tay AK, Rees S, Steel Z, Tam N, Soares Z, Soares C, Silove DM. Six-year trajectories of post-traumatic stress and severe psychological distress symptoms and associations with timing of trauma exposure, ongoing adversity and sense of injustice: a latent transition analysis of a community cohort in conflict-affected Timor-Leste. BMJ Open 2016; 6:e010205. [PMID: 26908525 PMCID: PMC4769389 DOI: 10.1136/bmjopen-2015-010205] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES To identify the 6-year trajectories of post-traumatic stress symptoms (PTSS) and psychological distress symptoms, and examine for associations with timing of trauma exposure, ongoing adversity and with the sense of injustice in conflict-affected Timor-Leste. SETTING A whole-of-household survey was conducted in 2004 and 2010 in Dili, the capital of Timor-Leste. PARTICIPANTS 1022 adults were followed up over 6 years (retention rate 84.5%). Interviews were conducted by field workers applying measures of traumatic events (TEs), ongoing adversity, a sense of injustice, PTS symptoms and psychological distress. RESULTS Latent transition analysis supported a 3-class longitudinal model (psychological distress, comorbid symptoms and low symptoms). We derived 4 composite trajectories comprising recovery (20.8%), a persisting morbidity trajectory (7.2%), an incident trajectory (37.2%) and a low-symptom trajectory (34.7%). Compared with the low-symptom trajectory, the persistent and incident trajectories reported greater stress arising from poverty and family conflict, higher TE exposure for 2 historical periods, and a sense of injustice for 2 historical periods. The persistent trajectory was unique in reporting greater TE exposure in the Indonesian occupation, whereas the incident trajectory reported greater TE exposure during the later internal conflict that occurred between baseline and follow-up. Compared with the low-symptom trajectory, the incident trajectory reported a greater sense of injustice relating to the periods of the Indonesian occupation and independence. The persistent trajectory was characterised by a sense of injustice relating to the internal conflict and contemporary times. The recovery trajectory was characterised by the absence of these risk factors, the only difference from the low-symptom trajectory being that the former reported a sense of injustice for the period surrounding independence. CONCLUSIONS Our findings suggest that the timing of both TE exposure and the focus of a sense of injustice may differentiate those with persisting and new-onset mental health morbidity in settings of recurrent conflict.
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Affiliation(s)
- AK Tay
- Psychiatry Research and Teaching Unit, University of New South Wales, Sydney, New South Wales, Australia
- Academic Mental Health Unit, Mental Health Centre, Liverpool Hospital, Sydney, New South Wales, Australia
| | - S Rees
- Psychiatry Research and Teaching Unit, University of New South Wales, Sydney, New South Wales, Australia
- Academic Mental Health Unit, Mental Health Centre, Liverpool Hospital, Sydney, New South Wales, Australia
| | - Z Steel
- St John of God Richmond Hospital, School of Psychiatry, University of New South Wales
| | - N Tam
- Psychiatry Research and Teaching Unit, University of New South Wales, Sydney, New South Wales, Australia
- Academic Mental Health Unit, Mental Health Centre, Liverpool Hospital, Sydney, New South Wales, Australia
| | - Z Soares
- Alola Foundation, Dili, Timor-Leste
| | - C Soares
- Alola Foundation, Dili, Timor-Leste
| | - DM Silove
- Psychiatry Research and Teaching Unit, University of New South Wales, Sydney, New South Wales, Australia
- Academic Mental Health Unit, Mental Health Centre, Liverpool Hospital, Sydney, New South Wales, Australia
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Rees SJ, Tol W, Mohammad M, Tay AK, Tam N, dos Reis N, da Costa E, Soares C, Silove DM, Silove DM. A high-risk group of pregnant women with elevated levels of conflict-related trauma, intimate partner violence, symptoms of depression and other forms of mental distress in post-conflict Timor-Leste. Transl Psychiatry 2016; 6:e725. [PMID: 26836413 PMCID: PMC4872420 DOI: 10.1038/tp.2015.212] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 11/01/2015] [Accepted: 11/05/2015] [Indexed: 11/18/2022] Open
Abstract
Women in low-income, post-conflict (LI-PC) [Corrected] countries are at risk of exposure to the traumatic events (TEs) of war and intimate partner violence (IPV), forms of stress that are known to lead to depression and other adverse mental health outcomes. We aimed to assess an index of exposure to these two forms of trauma to identify pregnant women attending antenatal clinics in conflict-affected Timor-Leste at high risk of depression and other forms of stress. A large, cross-sectional study of women in the second trimester of pregnancy was conducted in the four main government antenatal clinics in Dili district of Timor-Leste, between May 2014, and January 2015. The sample consisted of 1672 consecutive women, 3 to 6 months pregnant, with a response rate of 96%. We applied the Edinburgh Postnatal Depression Scale, the Kessler-10 psychological distress scale and the Harvard Trauma Questionnaire. IPV was assessed by the World Health Organisation measure. Composite categories of conflict-related TEs and severity of IPV showed a dose-response relationship with depressive symptoms: for exposure to four or more conflict-related TEs and severe psychological IPV, the adjusted odds ratio (AOR) was 3.95 (95% confidence interval (CI) 2.10-7.40); for four or more TEs and physical abuse, AOR 8.16 (95% CI 3.53-18.85); and for four or more TEs and severe psychological and physical abuse, AOR 9.78 (95% CI 5.31-18.02). For any mental distress, the AOR for four or more TEs and severe psychological abuse was 3.60 (95% CI 2.08-6.23); for four or more TEs and physical abuse 7.03 (95% CI 3.23-15.29); and for four or more TEs and severe psychological and physical abuse the AOR was 10.45 (95% CI 6.06-18.01). Of 184 women (11% of the sample) who reported ⩾ 4 TEs and either physical abuse alone or in combination with severe psychological abuse, 78 (42%) reached threshold for depressive symptoms and 93 (51%) for any mental distress, a 10-fold increase in depressive and other mental health symptoms. Priority should be directed to providing urgent mental health and social interventions for this group of women. Our findings offer a framework for a tiered approach to detection, guiding prevention and intervention strategies for IPV and associated mental health problems in low-income post-conflict countries.
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Affiliation(s)
- S J Rees
- Psychiatry Research and Teaching Unit, University of New South Wales and Academic Mental Health Unit, Mental Health Centre, Liverpool Hospital, Sydney, NSW, Australia,Psychiatry Research and Teaching Unit, University of New South Wales and Academic Mental Health Unit, Mental Health Centre, Liverpool Hospital, Sydney, NSW 2170, Australia. E-mail:
| | - W Tol
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - M Mohammad
- Psychiatry Research and Teaching Unit, University of New South Wales and Academic Mental Health Unit, Mental Health Centre, Liverpool Hospital, Sydney, NSW, Australia
| | - A K Tay
- Psychiatry Research and Teaching Unit, University of New South Wales and Academic Mental Health Unit, Mental Health Centre, Liverpool Hospital, Sydney, NSW, Australia
| | - N Tam
- Psychiatry Research and Teaching Unit, University of New South Wales and Academic Mental Health Unit, Mental Health Centre, Liverpool Hospital, Sydney, NSW, Australia
| | - N dos Reis
- Psychiatry Research and Teaching Unit, University of New South Wales and Academic Mental Health Unit, Mental Health Centre, Liverpool Hospital, Sydney, NSW, Australia,Child and Maternal Health, Alola Women's Foundation, Dili, Timor-Leste
| | - E da Costa
- Psychiatry Research and Teaching Unit, University of New South Wales and Academic Mental Health Unit, Mental Health Centre, Liverpool Hospital, Sydney, NSW, Australia,Child and Maternal Health, Alola Women's Foundation, Dili, Timor-Leste
| | - C Soares
- Psychiatry Research and Teaching Unit, University of New South Wales and Academic Mental Health Unit, Mental Health Centre, Liverpool Hospital, Sydney, NSW, Australia,Child and Maternal Health, Alola Women's Foundation, Dili, Timor-Leste
| | - D M Silove
- Psychiatry Research and Teaching Unit, University of New South Wales and Academic Mental Health Unit, Mental Health Centre, Liverpool Hospital, Sydney, NSW, Australia
| | - D M Silove
- Psychiatry Research and Teaching Unit, University of New South Wales and Academic Mental Health Unit, Mental Health Centre, Liverpool Hospital, Sydney, NSW, Australia
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Yacubian E, Manreza M, Dussan Ordoñe J, Nariño Gonzalez D, Ruiz-Sandoval J, Viana K, Vieira C, Moraes-Santos F, Lamarao F, Tobler J, Soares C, Valverde A. Refractory epilepsy in Latin America: sociodemographic, clinical characteristics and healthcare resources– the Latin America observational study on epilepsy patients (live). J Neurol Sci 2015. [DOI: 10.1016/j.jns.2015.08.536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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31
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Yacubian E, Manreza M, Dussan Ordoñe J, Nariño Gonzalez D, Ruiz-Sandoval J, Viana K, Vieira C, Moraes-Santos F, Lamarao F, Tobler J, Soares C, Valverde A. Recently diagnosed epilepsy in Latin America: sociodemographic, clinical characteristics and healthcare resources– Latin America observational study on epilepsy patients (live). J Neurol Sci 2015. [DOI: 10.1016/j.jns.2015.08.535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
Gastrointestinal duplications are rare congenital malformations seldom diagnosed in adulthood. They may vary greatly in size and location, with the small intestine being their major focus. Their clinical presentation is widely variable and unspecific, mimicking more common pathologies, thus making preoperative diagnosis very difficult. The intraoperative surgeon's experience and knowledge are crucial in recognising these lesions so that they can be correctly managed. In this report, the authors present a case of a 36-year-old man with an acute intestinal obstruction as the first presentation of ileal duplication.
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Affiliation(s)
- L Barbosa
- Department of General Surgery, Centro Hospitalar de Vila Nova de Gaia/Espinho, Porto, Portugal
| | - C Soares
- Department of General Surgery, Centro Hospitalar de Vila Nova de Gaia/Espinho, Porto, Portugal
| | - A A Póvoa
- Department of General Surgery, Centro Hospitalar de Vila Nova de Gaia/Espinho, Porto, Portugal
| | - J P Maciel
- Department of General Surgery, Centro Hospitalar de Vila Nova de Gaia/Espinho, Porto, Portugal
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33
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Oliveira LB, Lopes TS, Soares C, Maluf R, Goes BT, Sá KN, Baptista AF. Transcranial direct current stimulation and exercises for treatment of chronic temporomandibular disorders: a blind randomised-controlled trial. J Oral Rehabil 2015; 42:723-32. [PMID: 25891021 DOI: 10.1111/joor.12300] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2015] [Indexed: 11/28/2022]
Abstract
To evaluate the effect of adding transcranial direct current stimulation (tDCS) to exercises for chronic pain, dysfunction and quality of life in subjects with temporomandibular disorders (TMD). Participants were selected based on the RDC/TMD criteria and assessed for pain intensity, pressure pain threshold over temporomandibular joint and cervical muscles and quality of life. After initial assessment, all individuals underwent a 4-week protocol of exercises and manual therapy, together with active or sham primary motor cortex tDCS. Stimulation was delivered through sponge electrodes, with 2 mA amplitude, for 20 min daily, over the first 5 days of the trial. A total of 32 subjects (mean age 24.7 ± 6.8 years) participated in the evaluations and treatment protocol. Mean pain intensity pre-treatment was 5.5 ± 1.4 for active tDCS group, and 6.3 ± 1.2 for sham tDCS. Both groups showed a decrease in pain intensity scores during the trial period (time factor--F(4.5,137.5) = 28.7, P < 0.001; group factor--F(1.0,30.0 = 7.7), P < 0.05). However, there were no differences between the groups regarding change in pain intensity (time*group interaction--F(4.5,137.5) = 1.5, P = 0.137). This result remained the same after 5 months (t-test t = 0.29, P > 0.05). Pressure pain thresholds decrease and improvement in quality of life were also noticeable in both groups, but again without significant differences between them. Absolute benefit increase was 37.5% (CI 95%: -15.9% to 90.9%), and number needed to treat was 2.66. This study suggests that there is no additional benefit in adding tDCS to exercises for the treatment of chronic TMD in young adults.
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Affiliation(s)
- L B Oliveira
- Bahian School of Medicine and Human Health, Salvador, Brazil.,Adventist College of Bahia, Cachoeira, Brazil
| | - T S Lopes
- Adventist College of Bahia, Cachoeira, Brazil
| | - C Soares
- Adventist College of Bahia, Cachoeira, Brazil
| | - R Maluf
- Adventist College of Bahia, Cachoeira, Brazil
| | - B T Goes
- Bahian School of Medicine and Human Health, Salvador, Brazil
| | - K N Sá
- Bahian School of Medicine and Human Health, Salvador, Brazil.,Functional Electrostimulation Laboratory, Health Sciences Institute, Federal University of Bahia, Salvador, Brazil
| | - A F Baptista
- Bahian School of Medicine and Human Health, Salvador, Brazil.,Functional Electrostimulation Laboratory, Health Sciences Institute, Federal University of Bahia, Salvador, Brazil
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Marques I, Sá MJ, Soares G, Mota MDC, Pinheiro C, Aguiar L, Amado M, Soares C, Calado A, Dias P, Sousa AB, Fortuna AM, Santos R, Howell KB, Ryan MM, Leventer RJ, Sachdev R, Catford R, Friend K, Mattiske TR, Shoubridge C, Jorge P. Unraveling the pathogenesis of ARX polyalanine tract variants using a clinical and molecular interfacing approach. Mol Genet Genomic Med 2015; 3:203-14. [PMID: 26029707 PMCID: PMC4444162 DOI: 10.1002/mgg3.133] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Revised: 01/13/2015] [Accepted: 01/15/2015] [Indexed: 12/22/2022] Open
Abstract
The Aristaless-related homeobox (ARX) gene is implicated in intellectual disability with the most frequent pathogenic mutations leading to expansions of the first two polyalanine tracts. Here, we describe analysis of the ARX gene outlining the approaches in the Australian and Portuguese setting, using an integrated clinical and molecular strategy. We report variants in the ARX gene detected in 19 patients belonging to 17 families. Seven pathogenic variants, being expansion mutations in both polyalanine tract 1 and tract 2, were identifyed, including a novel mutation in polyalanine tract 1 that expands the first tract to 20 alanines. This precise number of alanines is sufficient to cause pathogenicity when expanded in polyalanine tract 2. Five cases presented a probably non-pathogenic variant, including the novel HGVS: c.441_455del, classified as unlikely disease causing, consistent with reports that suggest that in frame deletions in polyalanine stretches of ARX rarely cause intellectual disability. In addition, we identified five cases with a variant of unclear pathogenic significance. Owing to the inconsistent ARX variants description, publications were reviewed and ARX variant classifications were standardized and detailed unambiguously according to recommendations of the Human Genome Variation Society. In the absence of a pathognomonic clinical feature, we propose that molecular analysis of the ARX gene should be included in routine diagnostic practice in individuals with either nonsyndromic or syndromic intellectual disability. A definitive diagnosis of ARX-related disorders is crucial for an adequate clinical follow-up and accurate genetic counseling of at-risk family members.
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Affiliation(s)
- Isabel Marques
- Unidade de Genética Molecular, Centro de Genética Médica Doutor Jacinto Magalhães, Centro Hospitalar do Porto, EPE Porto, Portugal ; Unit for Multidisciplinary Research in Biomedicine, UMIB, ICBAS-UP Porto, Portugal
| | - Maria João Sá
- Unidade de Genética Médica, Centro de Genética Médica Doutor Jacinto Magalhães, Centro Hospitalar do Porto, EPE Porto, Portugal ; Unit for Multidisciplinary Research in Biomedicine, UMIB, ICBAS-UP Porto, Portugal
| | - Gabriela Soares
- Unidade de Genética Médica, Centro de Genética Médica Doutor Jacinto Magalhães, Centro Hospitalar do Porto, EPE Porto, Portugal
| | - Maria do Céu Mota
- Department of Pediatrics, Centro Hospitalar do Porto, EPE Porto, Portugal
| | - Carla Pinheiro
- Department of Pediatrics, Hospital Santa Maria Maior, EPE Barcelos, Portugal
| | - Lisa Aguiar
- Department of Pediatrics, Hospital Distrital de Santarém, EPE Santarém, Portugal
| | - Marta Amado
- Department of Pediatrics, Unidade Hospitalar de Portimão, Centro Hospitalar do Algarve Portimão, Portugal
| | - Christina Soares
- Department of Pediatrics, Unidade Hospitalar de Portimão, Centro Hospitalar do Algarve Portimão, Portugal
| | - Angelina Calado
- Department of Pediatrics, Unidade Hospitalar de Portimão, Centro Hospitalar do Algarve Portimão, Portugal
| | - Patrícia Dias
- Department of Genetics, Hospital de Santa Maria Lisboa, Portugal
| | - Ana Berta Sousa
- Department of Genetics, Hospital de Santa Maria Lisboa, Portugal
| | - Ana Maria Fortuna
- Unidade de Genética Médica, Centro de Genética Médica Doutor Jacinto Magalhães, Centro Hospitalar do Porto, EPE Porto, Portugal ; Unit for Multidisciplinary Research in Biomedicine, UMIB, ICBAS-UP Porto, Portugal
| | - Rosário Santos
- Unidade de Genética Molecular, Centro de Genética Médica Doutor Jacinto Magalhães, Centro Hospitalar do Porto, EPE Porto, Portugal ; Unit for Multidisciplinary Research in Biomedicine, UMIB, ICBAS-UP Porto, Portugal
| | - Katherine B Howell
- Department of Neurology, Royal Children's Hospital Melbourne, Victoria, Australia ; Murdoch Childrens Research Institute Melbourne, Victoria, Australia, 3052 ; University of Melbourne Department of Paediatrics Melbourne, Victoria, Australia, 3052
| | - Monique M Ryan
- Department of Neurology, Royal Children's Hospital Melbourne, Victoria, Australia ; Murdoch Childrens Research Institute Melbourne, Victoria, Australia, 3052 ; University of Melbourne Department of Paediatrics Melbourne, Victoria, Australia, 3052
| | - Richard J Leventer
- Department of Neurology, Royal Children's Hospital Melbourne, Victoria, Australia ; Murdoch Childrens Research Institute Melbourne, Victoria, Australia, 3052 ; University of Melbourne Department of Paediatrics Melbourne, Victoria, Australia, 3052
| | - Rani Sachdev
- Department of Medical Genetics, Sydney Children's Hospital High St., Randwick, New South Wales, 2031, Australia
| | - Rachael Catford
- SA Pathology at the Women's and Children's Hospital North Adelaide, South Australia, Australia
| | - Kathryn Friend
- SA Pathology at the Women's and Children's Hospital North Adelaide, South Australia, Australia
| | - Tessa R Mattiske
- Department of Paediatrics, University of Adelaide Adelaide, South Australia, 5006, Australia ; Robinson Research Institute, University of Adelaide Adelaide, South Australia, 5006, Australia
| | - Cheryl Shoubridge
- Department of Paediatrics, University of Adelaide Adelaide, South Australia, 5006, Australia ; Robinson Research Institute, University of Adelaide Adelaide, South Australia, 5006, Australia
| | - Paula Jorge
- Unidade de Genética Molecular, Centro de Genética Médica Doutor Jacinto Magalhães, Centro Hospitalar do Porto, EPE Porto, Portugal ; Unit for Multidisciplinary Research in Biomedicine, UMIB, ICBAS-UP Porto, Portugal
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Nabais Sá MJ, Storey H, Flinter F, Nagel M, Sampaio S, Castro R, Araújo JA, Gaspar MA, Soares C, Oliveira A, Henriques AC, da Costa AG, Abreu CP, Ponce P, Alves R, Pinho L, Silva SE, de Moura CP, Mendonça L, Carvalho F, Pestana M, Alves S, Carvalho F, Oliveira JP. Collagen type IV-related nephropathies in Portugal: pathogenic COL4A3 and COL4A4 mutations and clinical characterization of 25 families. Clin Genet 2014; 88:456-61. [PMID: 25307543 DOI: 10.1111/cge.12521] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2014] [Revised: 10/04/2014] [Accepted: 10/06/2014] [Indexed: 12/22/2022]
Abstract
Pathogenic mutations in genes COL4A3/COL4A4 are responsible for autosomal Alport syndrome (AS) and thin basement membrane nephropathy (TBMN). We used Sanger sequencing to analyze all exons and splice site regions of COL4A3/COL4A4, in 40 unrelated Portuguese probands with clinical suspicion of AS/TBMN. To assess genotype-phenotype correlations, we compared clinically relevant phenotypes/outcomes between homozygous/compound heterozygous and apparently heterozygous patients. Seventeen novel and four reportedly pathogenic COL4A3/COL4A4 mutations were identified in 62.5% (25/40) of the probands. Regardless of the mutated gene, all patients with ARAS manifested chronic renal failure (CRF) and hearing loss, whereas a minority of the apparently heterozygous patients had CRF or extrarenal symptoms. CRF was diagnosed at a significantly younger age in patients with ARAS. In our families, the occurrence of COL4A3/COL4A4 mutations was higher, while the prevalence of XLAS was lower than expected. Overall, a pathogenic COL4A3/COL4A4/COL4A5 mutation was identified in >50% of patients with fewer than three of the standard diagnostic criteria of AS. With such a population background, simultaneous next-generation sequencing of all three genes may be recommended as the most expedite approach to diagnose collagen IV-related glomerular basement membrane nephropathies.
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Affiliation(s)
- M J Nabais Sá
- Department of Genetics, Faculty of Medicine, Porto, Portugal.,Unit of Research and Development of Nephrology (FCT-725), Faculty of Medicine, University of Porto, Porto, Portugal
| | - H Storey
- Molecular Genetics Laboratory, Viapath, UK
| | - F Flinter
- Genetics Centre, Guy's and St. Thomas' Hospital National Health Service Foundation Trust, London, UK
| | - M Nagel
- Center for Nephrology and Metabolic Diseases, Weisswasser, Germany
| | - S Sampaio
- Unit of Research and Development of Nephrology (FCT-725), Faculty of Medicine, University of Porto, Porto, Portugal.,Department of Nephrology, Hospital de São João, Porto, Portugal
| | - R Castro
- Department of Nephrology, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, Portugal
| | - J A Araújo
- Department of Nephrology, Hospital dos Marmeleiros, Funchal, Portugal
| | - M A Gaspar
- Dialysis Clinic, NephroCare Restelo, Fresenius Medical Care, Lisboa, Portugal
| | - C Soares
- Department of Nephrology, Hospital de Braga, Braga, Portugal
| | - A Oliveira
- Dialysis Clinic Paredes, Diaverum, Paredes, Portugal
| | - A C Henriques
- Dialysis Clinic, NephroCare Braga, Fresenius Medical Care, Braga, Portugal
| | - A G da Costa
- Department of Nephrology, Hospital de Santa Maria, Lisboa, Portugal
| | - C P Abreu
- Dialysis Clinic Lumiar, Diaverum, Lisboa, Portugal
| | - P Ponce
- Dialysis Clinic, NephroCare Lumiar, Fresenius Medical Care, Lisboa, Portugal
| | - R Alves
- Dialysis Clinic, NephroCare Viseu, Fresenius Medical Care, Viseu, Portugal
| | - L Pinho
- Dialysis Clinic Paredes, Diaverum, Paredes, Portugal
| | - S E Silva
- Department of Ophthalmology, Porto, Portugal
| | - C P de Moura
- Department of Otolaryngology, Porto, Portugal.,Medical Genetics Outpatient Clinic, Hospital de São João, Porto, Portugal
| | - L Mendonça
- Department of Ophthalmology, Hospital de Braga, Braga, Portugal
| | - F Carvalho
- Unit of Renal Morphology, Department of Nephrology, Hospital Curry Cabral, Lisboa, Portugal
| | - M Pestana
- Unit of Research and Development of Nephrology (FCT-725), Faculty of Medicine, University of Porto, Porto, Portugal.,Department of Nephrology, Hospital de São João, Porto, Portugal
| | - S Alves
- Department of Genetics, Faculty of Medicine, Porto, Portugal
| | - F Carvalho
- Department of Genetics, Faculty of Medicine, Porto, Portugal
| | - J P Oliveira
- Department of Genetics, Faculty of Medicine, Porto, Portugal.,Unit of Research and Development of Nephrology (FCT-725), Faculty of Medicine, University of Porto, Porto, Portugal.,Medical Genetics Outpatient Clinic, Hospital de São João, Porto, Portugal
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Nabais Sá MJ, Sampaio S, Oliveira A, Alves S, Moura CP, Silva SE, Castro R, Araújo JA, Rodrigues M, Neves F, Seabra J, Soares C, Gaspar MA, Tavares I, Freitas L, Sousa TC, Henriques AC, Costa FT, Morgado E, Sousa FT, Sousa JP, da Costa AG, Filipe R, Garrido J, Montalban J, Ponce P, Alves R, Faria B, Carvalho MF, Pestana M, Carvalho F, Oliveira JP. Collagen type IV-related nephropathies in Portugal: pathogenic COL4A5 mutations and clinical characterization of 22 families. Clin Genet 2014; 88:462-7. [PMID: 25307721 DOI: 10.1111/cge.12522] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Revised: 10/08/2014] [Accepted: 10/08/2014] [Indexed: 11/28/2022]
Abstract
Alport syndrome (AS) is caused by pathogenic mutations in the genes encoding α3, α4 or α5 chains of collagen IV (COL4A3/COL4A4/COL4A5), resulting in hematuria, chronic renal failure (CRF), sensorineural hearing loss (SNHL) and ocular abnormalities. Mutations in the X-linked COL4A5 gene have been identified in 85% of the families (XLAS). In this study, 22 of 60 probands (37%) of unrelated Portuguese families, with clinical diagnosis of AS and no evidence of autosomal inheritance, had pathogenic COL4A5 mutations detected by Sanger sequencing and/or multiplex-ligation probe amplification, of which 12 (57%) are novel. Males had more severe and earlier renal and extrarenal complications, but microscopic hematuria was a constant finding irrespective of gender. Nonsense and splice site mutations, as well as small and large deletions, were associated with younger age of onset of SNHL in males, and with higher risk of CRF and SNHL in females. Pathogenic COL4A3 or COL4A4 mutations were subsequently identified in more than half of the families without a pathogenic mutation in COL4A5. The lower than expected prevalence of XLAS in Portuguese families warrants the use of next-generation sequencing for simultaneous COL4A3/COL4A4/COL4A5 analysis, as first-tier approach to the genetic diagnosis of collagen type IV-related nephropathies.
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Affiliation(s)
- M J Nabais Sá
- Department of Genetics, Faculty of Medicine, Porto, Portugal.,Unit of Research and Development of Nephrology (FCT-725), Faculty of Medicine, University of Porto, Porto, Portugal
| | - S Sampaio
- Unit of Research and Development of Nephrology (FCT-725), Faculty of Medicine, University of Porto, Porto, Portugal.,Department of Nephrology, Porto, Portugal
| | - A Oliveira
- Department of Nephrology, Porto, Portugal
| | - S Alves
- Department of Genetics, Faculty of Medicine, Porto, Portugal
| | - C P Moura
- Department of Otolaryngology, Porto, Portugal.,Medical Genetics Outpatient Clinic, Porto, Portugal
| | - S E Silva
- Department of Ophthalmology, Hospital de São João, Porto, Portugal
| | - R Castro
- Department of Nephrology, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, Portugal
| | - J A Araújo
- Department of Nephrology, Hospital dos Marmeleiros, Funchal, Portugal
| | - M Rodrigues
- Department of Medical Genetics, Hospital Dona Estefânia, Lisboa, Portugal
| | - F Neves
- Dialysis Clinic of Santarém, NephroCare-Portugal, Santarém, Portugal
| | - J Seabra
- Department of Nephrology, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - C Soares
- Department of Nephrology, Hospital de Braga, Braga, Portugal
| | - M A Gaspar
- Dialysis Clinic of Restelo, NephroCare-Portugal, Lisboa, Portugal
| | - I Tavares
- Unit of Research and Development of Nephrology (FCT-725), Faculty of Medicine, University of Porto, Porto, Portugal.,Dialysis Clinic of Santo Tirso, Uninefro, Santo Tirso, Portugal
| | - L Freitas
- Department of Nephrology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - T C Sousa
- Department of Nephrology, Hospital de São Teotónio, Viseu, Portugal.,Dialysis Clinic of Guarda, NephroCare-Portugal, Guarda, Portugal
| | - A C Henriques
- Dialysis Clinic of Braga, NephroCare-Portugal, Braga, Portugal
| | - F T Costa
- Department of Nephrology, Hospital Garcia de Orta, Almada, Portugal
| | - E Morgado
- Department of Nephrology, Hospital de Faro, Faro, Portugal
| | - F T Sousa
- Dialysis Clinic of Montijo, NephroCare-Portugal, Montijo, Portugal
| | - J P Sousa
- Department of Nephrology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.,Dialysis Clinic of Coimbra, NephroCare-Portugal, Coimbra, Portugal
| | - A G da Costa
- Department of Nephrology, Hospital de Santa Maria, Lisboa, Portugal
| | - R Filipe
- Department of Nephrology, Hospital Amato Lusitano, Castelo Branco, Portugal
| | - J Garrido
- Department of Nephrology, Hospital de São Teotónio, Viseu, Portugal
| | - J Montalban
- Dialysis Clinic of Covilhã, NephroCare-Portugal, Covilhã, Portugal
| | - P Ponce
- Dialysis Clinic of Lumiar, NephroCare-Portugal, Lisboa, Portugal
| | - R Alves
- Dialysis Clinic of Viseu, NephroCare-Portugal, Viseu, Portugal
| | - B Faria
- Dialysis Clinic of Guarda, NephroCare-Portugal, Guarda, Portugal
| | - M F Carvalho
- Unit of Renal Morphology, Department of Nephrology, Hospital Curry Cabral, Lisboa, Portugal
| | - M Pestana
- Unit of Research and Development of Nephrology (FCT-725), Faculty of Medicine, University of Porto, Porto, Portugal.,Department of Nephrology, Porto, Portugal
| | - F Carvalho
- Department of Genetics, Faculty of Medicine, Porto, Portugal
| | - J P Oliveira
- Department of Genetics, Faculty of Medicine, Porto, Portugal.,Unit of Research and Development of Nephrology (FCT-725), Faculty of Medicine, University of Porto, Porto, Portugal.,Medical Genetics Outpatient Clinic, Porto, Portugal
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Gomes E, Soares C, Pinto L, Melo RB. 333. Health-related quality of life of patients with hepatocellular carcinoma submitted to multiple therapy modalities. Eur J Surg Oncol 2014. [DOI: 10.1016/j.ejso.2014.08.323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Skoronski E, Padoin N, Soares C, Furigo Jr. A. Stability of immobilized Rhizomucor miehei lipase for the synthesis of pentyl octanoate in a continuous packed bed bioreactor. Braz J Chem Eng 2014. [DOI: 10.1590/0104-6632.20140313s00002978] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- E. Skoronski
- Universidade do Estado de Santa Catarina, Brasil
| | - N. Padoin
- Universidade Federal de Santa Catarina, Brasil
| | - C. Soares
- Universidade Federal de Santa Catarina, Brasil
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Riley A, Soares C, Micka J, Culberson W, DeWerd L. WE-A-17A-01: Absorbed Dose Rate-To-Water at the Surface of a Beta-Emitting Planar Ophthalmic Applicator with a Planar, Windowless Extrapolation Chamber. Med Phys 2014. [DOI: 10.1118/1.4889371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Gomes F, Gonçalves D, Gonçalves M, Nascimento M, Novo R, Soares C. EPA-1732 – Gender transition: biological and psychosocial features of adjusting to sex reassignment - crossing literature with psychometric data from a clinical sexology unit in lisbon. Eur Psychiatry 2014. [DOI: 10.1016/s0924-9338(14)78866-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Monteiro A, Ramos R, Labandeiro J, Fiarresga A, Sousa L, Cacela D, Patricio L, Bernardes L, Soares C, Cruz Ferreira R. Stent thrombosis after primary angioplasty - incidence, timing and long term prognostic: 5 year follow-up registry. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.p4889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Massillon-jl G, Minniti R, O' Brien M, Soares C. SU-E-T-86: An Investigation of the Energy Dependence of LiF:Mg,Ti Thermoluminescent Dosimeters in Photon Beams. Med Phys 2013. [DOI: 10.1118/1.4814521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Rosen B, Soares C, Minniti R, DeWerd L. WE-E-141-03: Comparative Study of Novel Versus Conventional Scanning Modalities for Radiochromic Film Dosimetry. Med Phys 2013. [DOI: 10.1118/1.4815594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Soares C, Noriler D, Wolf Maciel MR, Barros AAC, Meier HF. Verification and validation in CFD for a free-surface gas-liquid flow in channels. Braz J Chem Eng 2013. [DOI: 10.1590/s0104-66322013000200010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- C. Soares
- Universidade Federal de Santa Catarina, Brasil
| | - D. Noriler
- Universidade Regional de Blumenau, Brasil
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Abulkhair O, Uslu R, Sezgin C, Büyükberber S, Darwish T, Isikdogan A, Gumus M, Dane F, Sevinc A, Halawani H, Uncu D, Marrero N, Tobler J, Soares C, Landis S, Moraes E, Gidekel R, Santillana S, Nunez P, Cagnolati S, Rodriguez JG. Abstract OT1-1-08: Clinical outcomes among ErbB2+ MBC patients treated with lapatinib-capecitabine after trastuzumab progression: Role of early switch to lapatinib (TYCO study). Cancer Res 2012. [DOI: 10.1158/0008-5472.sabcs12-ot1-1-08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Lapatinib in combination with capecitabine is a standard of care treatment for ErbB2+ metastatic breast cancer (MBC) patients who have progressed after anthracyclines, taxanes and trastuzumab treatment. Results from the lapatinib pivotal trial showed that the addition of lapatinib to capecitabine increased median time to progression (TTP) even among heavily pre-treated patients (median of 4 prior lines of therapy). A post-hoc exploratory sub-group analysis of this trial suggested that earlier administration of lapatinib-capecitabine in MBC patients who progress after trastuzumab may produce better clinical outcomes. The TYCO study was designed to evaluate if early initiation of lapatinib-capecitabine in patients with ErbB2+ MBC who have progressed on trastuzumab-containing regimen improves TTP in comparison with a delayed start of the therapy.
Trial design: TYCO is an international, multicenter, prospective, observational study in 269 ErbB2+ MBC patients whose disease has progressed after treatment with trastuzumab in the metastatic setting. Two cohorts will be compared; Group 1: patients receiving lapatinib-capecitabine just after the first trastuzumab progression, and Group 2: patients receiving lapatinib-capecitabine after two or more lines of treatment after first trastuzumab progression. The study duration is of 12 months with data collection at baseline and approximately every 3 months thereafter.
Major Eligibility Criteria: 1. Females ≥18y with confirmed ErbB2+ MBC who have progressed after a previous trastuzumab-containing regimen,2. Pts eligible for standard therapy with lapatinib-capecitabine at approved conventional doses, as per local approved label.3. Pts eligible to start standard treatment with Lapatinib-capecitabine at conventional doses, or receiving standard treatment with Lapatinib-capecitabine at conventional doses, for no longer than 10 weeks from the start of the treatment to the date of inclusion in the study;
Aims: Primary objective of this study is to determine if early switch to lapatinib-capecitabine in patients with ErbB2+ metastatic breast cancer who have progressed on trastuzumab containing regimen improves time to disease progression as determined by treating physician either clinically or radiologically. Secondary objectives include overall response rate and overall survival.
Statistical Methods: Kaplan-Meier plots will be used to describe the median TTP after start of lapatinib-capecetabine. Cox proportional hazard model will be developed to estimate the adjusted hazard ratio (and 95% confidence intervals) comparing TTP for the two treatment group using propensity score methods (trimmed sample, adjustment for the continuous propensity score measure, and doubly robust adjustment) to adjust for potential confounding by indication that may arise due to the non-randomised design.
Present and Target Accrual: Enrollment began in February 2010, and as per May 2012, 266 patients have been included from Turkey, Venezuela, Argentina, Saudi Arabia and Colombia.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr OT1-1-08.
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Affiliation(s)
- O Abulkhair
- Ege University Medical Faculty, Izmir, Turkey; Gazi University Medical Faculty, Ankara, Turkey; King Abdulaziz Medical City National Guard Health Affairs, Riyadh, Saudi Arabia; King Abdullah Medical City - Oncology Centre, Jeddah, Saudi Arabia; Dicle University Medical Faculty, Diyarbakir, Turkey; Kartal Training and Research Hospital, Istanbul, Turkey; Marmara University Training and Research Hospital, Istanbul, Turkey; Gaziantep University Medical Faculty, Gaziantep, Turkey; King Fahad Specialist Hospital, Dammam, Saudi Arabia; Numune Training and Research Hosptial, Ankara, Turkey; Instituto Docente de Urología, Valencia, Venezuela; GlaxoSmithKline, Rio de Janeiro, Brazil; GlaxoSmithKline, Buenos Aires, Argentina; GlaxoSmithKline, Stockley Park, United Kingdom; Hospital Oncológico Padre Machado, Caracas, Venezuela; Centro Oncologico-FIDES-La Plata, Buenos Aires, Argentina
| | - R Uslu
- Ege University Medical Faculty, Izmir, Turkey; Gazi University Medical Faculty, Ankara, Turkey; King Abdulaziz Medical City National Guard Health Affairs, Riyadh, Saudi Arabia; King Abdullah Medical City - Oncology Centre, Jeddah, Saudi Arabia; Dicle University Medical Faculty, Diyarbakir, Turkey; Kartal Training and Research Hospital, Istanbul, Turkey; Marmara University Training and Research Hospital, Istanbul, Turkey; Gaziantep University Medical Faculty, Gaziantep, Turkey; King Fahad Specialist Hospital, Dammam, Saudi Arabia; Numune Training and Research Hosptial, Ankara, Turkey; Instituto Docente de Urología, Valencia, Venezuela; GlaxoSmithKline, Rio de Janeiro, Brazil; GlaxoSmithKline, Buenos Aires, Argentina; GlaxoSmithKline, Stockley Park, United Kingdom; Hospital Oncológico Padre Machado, Caracas, Venezuela; Centro Oncologico-FIDES-La Plata, Buenos Aires, Argentina
| | - C Sezgin
- Ege University Medical Faculty, Izmir, Turkey; Gazi University Medical Faculty, Ankara, Turkey; King Abdulaziz Medical City National Guard Health Affairs, Riyadh, Saudi Arabia; King Abdullah Medical City - Oncology Centre, Jeddah, Saudi Arabia; Dicle University Medical Faculty, Diyarbakir, Turkey; Kartal Training and Research Hospital, Istanbul, Turkey; Marmara University Training and Research Hospital, Istanbul, Turkey; Gaziantep University Medical Faculty, Gaziantep, Turkey; King Fahad Specialist Hospital, Dammam, Saudi Arabia; Numune Training and Research Hosptial, Ankara, Turkey; Instituto Docente de Urología, Valencia, Venezuela; GlaxoSmithKline, Rio de Janeiro, Brazil; GlaxoSmithKline, Buenos Aires, Argentina; GlaxoSmithKline, Stockley Park, United Kingdom; Hospital Oncológico Padre Machado, Caracas, Venezuela; Centro Oncologico-FIDES-La Plata, Buenos Aires, Argentina
| | - S Büyükberber
- Ege University Medical Faculty, Izmir, Turkey; Gazi University Medical Faculty, Ankara, Turkey; King Abdulaziz Medical City National Guard Health Affairs, Riyadh, Saudi Arabia; King Abdullah Medical City - Oncology Centre, Jeddah, Saudi Arabia; Dicle University Medical Faculty, Diyarbakir, Turkey; Kartal Training and Research Hospital, Istanbul, Turkey; Marmara University Training and Research Hospital, Istanbul, Turkey; Gaziantep University Medical Faculty, Gaziantep, Turkey; King Fahad Specialist Hospital, Dammam, Saudi Arabia; Numune Training and Research Hosptial, Ankara, Turkey; Instituto Docente de Urología, Valencia, Venezuela; GlaxoSmithKline, Rio de Janeiro, Brazil; GlaxoSmithKline, Buenos Aires, Argentina; GlaxoSmithKline, Stockley Park, United Kingdom; Hospital Oncológico Padre Machado, Caracas, Venezuela; Centro Oncologico-FIDES-La Plata, Buenos Aires, Argentina
| | - T Darwish
- Ege University Medical Faculty, Izmir, Turkey; Gazi University Medical Faculty, Ankara, Turkey; King Abdulaziz Medical City National Guard Health Affairs, Riyadh, Saudi Arabia; King Abdullah Medical City - Oncology Centre, Jeddah, Saudi Arabia; Dicle University Medical Faculty, Diyarbakir, Turkey; Kartal Training and Research Hospital, Istanbul, Turkey; Marmara University Training and Research Hospital, Istanbul, Turkey; Gaziantep University Medical Faculty, Gaziantep, Turkey; King Fahad Specialist Hospital, Dammam, Saudi Arabia; Numune Training and Research Hosptial, Ankara, Turkey; Instituto Docente de Urología, Valencia, Venezuela; GlaxoSmithKline, Rio de Janeiro, Brazil; GlaxoSmithKline, Buenos Aires, Argentina; GlaxoSmithKline, Stockley Park, United Kingdom; Hospital Oncológico Padre Machado, Caracas, Venezuela; Centro Oncologico-FIDES-La Plata, Buenos Aires, Argentina
| | - A Isikdogan
- Ege University Medical Faculty, Izmir, Turkey; Gazi University Medical Faculty, Ankara, Turkey; King Abdulaziz Medical City National Guard Health Affairs, Riyadh, Saudi Arabia; King Abdullah Medical City - Oncology Centre, Jeddah, Saudi Arabia; Dicle University Medical Faculty, Diyarbakir, Turkey; Kartal Training and Research Hospital, Istanbul, Turkey; Marmara University Training and Research Hospital, Istanbul, Turkey; Gaziantep University Medical Faculty, Gaziantep, Turkey; King Fahad Specialist Hospital, Dammam, Saudi Arabia; Numune Training and Research Hosptial, Ankara, Turkey; Instituto Docente de Urología, Valencia, Venezuela; GlaxoSmithKline, Rio de Janeiro, Brazil; GlaxoSmithKline, Buenos Aires, Argentina; GlaxoSmithKline, Stockley Park, United Kingdom; Hospital Oncológico Padre Machado, Caracas, Venezuela; Centro Oncologico-FIDES-La Plata, Buenos Aires, Argentina
| | - M Gumus
- Ege University Medical Faculty, Izmir, Turkey; Gazi University Medical Faculty, Ankara, Turkey; King Abdulaziz Medical City National Guard Health Affairs, Riyadh, Saudi Arabia; King Abdullah Medical City - Oncology Centre, Jeddah, Saudi Arabia; Dicle University Medical Faculty, Diyarbakir, Turkey; Kartal Training and Research Hospital, Istanbul, Turkey; Marmara University Training and Research Hospital, Istanbul, Turkey; Gaziantep University Medical Faculty, Gaziantep, Turkey; King Fahad Specialist Hospital, Dammam, Saudi Arabia; Numune Training and Research Hosptial, Ankara, Turkey; Instituto Docente de Urología, Valencia, Venezuela; GlaxoSmithKline, Rio de Janeiro, Brazil; GlaxoSmithKline, Buenos Aires, Argentina; GlaxoSmithKline, Stockley Park, United Kingdom; Hospital Oncológico Padre Machado, Caracas, Venezuela; Centro Oncologico-FIDES-La Plata, Buenos Aires, Argentina
| | - F Dane
- Ege University Medical Faculty, Izmir, Turkey; Gazi University Medical Faculty, Ankara, Turkey; King Abdulaziz Medical City National Guard Health Affairs, Riyadh, Saudi Arabia; King Abdullah Medical City - Oncology Centre, Jeddah, Saudi Arabia; Dicle University Medical Faculty, Diyarbakir, Turkey; Kartal Training and Research Hospital, Istanbul, Turkey; Marmara University Training and Research Hospital, Istanbul, Turkey; Gaziantep University Medical Faculty, Gaziantep, Turkey; King Fahad Specialist Hospital, Dammam, Saudi Arabia; Numune Training and Research Hosptial, Ankara, Turkey; Instituto Docente de Urología, Valencia, Venezuela; GlaxoSmithKline, Rio de Janeiro, Brazil; GlaxoSmithKline, Buenos Aires, Argentina; GlaxoSmithKline, Stockley Park, United Kingdom; Hospital Oncológico Padre Machado, Caracas, Venezuela; Centro Oncologico-FIDES-La Plata, Buenos Aires, Argentina
| | - A Sevinc
- Ege University Medical Faculty, Izmir, Turkey; Gazi University Medical Faculty, Ankara, Turkey; King Abdulaziz Medical City National Guard Health Affairs, Riyadh, Saudi Arabia; King Abdullah Medical City - Oncology Centre, Jeddah, Saudi Arabia; Dicle University Medical Faculty, Diyarbakir, Turkey; Kartal Training and Research Hospital, Istanbul, Turkey; Marmara University Training and Research Hospital, Istanbul, Turkey; Gaziantep University Medical Faculty, Gaziantep, Turkey; King Fahad Specialist Hospital, Dammam, Saudi Arabia; Numune Training and Research Hosptial, Ankara, Turkey; Instituto Docente de Urología, Valencia, Venezuela; GlaxoSmithKline, Rio de Janeiro, Brazil; GlaxoSmithKline, Buenos Aires, Argentina; GlaxoSmithKline, Stockley Park, United Kingdom; Hospital Oncológico Padre Machado, Caracas, Venezuela; Centro Oncologico-FIDES-La Plata, Buenos Aires, Argentina
| | - H Halawani
- Ege University Medical Faculty, Izmir, Turkey; Gazi University Medical Faculty, Ankara, Turkey; King Abdulaziz Medical City National Guard Health Affairs, Riyadh, Saudi Arabia; King Abdullah Medical City - Oncology Centre, Jeddah, Saudi Arabia; Dicle University Medical Faculty, Diyarbakir, Turkey; Kartal Training and Research Hospital, Istanbul, Turkey; Marmara University Training and Research Hospital, Istanbul, Turkey; Gaziantep University Medical Faculty, Gaziantep, Turkey; King Fahad Specialist Hospital, Dammam, Saudi Arabia; Numune Training and Research Hosptial, Ankara, Turkey; Instituto Docente de Urología, Valencia, Venezuela; GlaxoSmithKline, Rio de Janeiro, Brazil; GlaxoSmithKline, Buenos Aires, Argentina; GlaxoSmithKline, Stockley Park, United Kingdom; Hospital Oncológico Padre Machado, Caracas, Venezuela; Centro Oncologico-FIDES-La Plata, Buenos Aires, Argentina
| | - D Uncu
- Ege University Medical Faculty, Izmir, Turkey; Gazi University Medical Faculty, Ankara, Turkey; King Abdulaziz Medical City National Guard Health Affairs, Riyadh, Saudi Arabia; King Abdullah Medical City - Oncology Centre, Jeddah, Saudi Arabia; Dicle University Medical Faculty, Diyarbakir, Turkey; Kartal Training and Research Hospital, Istanbul, Turkey; Marmara University Training and Research Hospital, Istanbul, Turkey; Gaziantep University Medical Faculty, Gaziantep, Turkey; King Fahad Specialist Hospital, Dammam, Saudi Arabia; Numune Training and Research Hosptial, Ankara, Turkey; Instituto Docente de Urología, Valencia, Venezuela; GlaxoSmithKline, Rio de Janeiro, Brazil; GlaxoSmithKline, Buenos Aires, Argentina; GlaxoSmithKline, Stockley Park, United Kingdom; Hospital Oncológico Padre Machado, Caracas, Venezuela; Centro Oncologico-FIDES-La Plata, Buenos Aires, Argentina
| | - N Marrero
- Ege University Medical Faculty, Izmir, Turkey; Gazi University Medical Faculty, Ankara, Turkey; King Abdulaziz Medical City National Guard Health Affairs, Riyadh, Saudi Arabia; King Abdullah Medical City - Oncology Centre, Jeddah, Saudi Arabia; Dicle University Medical Faculty, Diyarbakir, Turkey; Kartal Training and Research Hospital, Istanbul, Turkey; Marmara University Training and Research Hospital, Istanbul, Turkey; Gaziantep University Medical Faculty, Gaziantep, Turkey; King Fahad Specialist Hospital, Dammam, Saudi Arabia; Numune Training and Research Hosptial, Ankara, Turkey; Instituto Docente de Urología, Valencia, Venezuela; GlaxoSmithKline, Rio de Janeiro, Brazil; GlaxoSmithKline, Buenos Aires, Argentina; GlaxoSmithKline, Stockley Park, United Kingdom; Hospital Oncológico Padre Machado, Caracas, Venezuela; Centro Oncologico-FIDES-La Plata, Buenos Aires, Argentina
| | - J Tobler
- Ege University Medical Faculty, Izmir, Turkey; Gazi University Medical Faculty, Ankara, Turkey; King Abdulaziz Medical City National Guard Health Affairs, Riyadh, Saudi Arabia; King Abdullah Medical City - Oncology Centre, Jeddah, Saudi Arabia; Dicle University Medical Faculty, Diyarbakir, Turkey; Kartal Training and Research Hospital, Istanbul, Turkey; Marmara University Training and Research Hospital, Istanbul, Turkey; Gaziantep University Medical Faculty, Gaziantep, Turkey; King Fahad Specialist Hospital, Dammam, Saudi Arabia; Numune Training and Research Hosptial, Ankara, Turkey; Instituto Docente de Urología, Valencia, Venezuela; GlaxoSmithKline, Rio de Janeiro, Brazil; GlaxoSmithKline, Buenos Aires, Argentina; GlaxoSmithKline, Stockley Park, United Kingdom; Hospital Oncológico Padre Machado, Caracas, Venezuela; Centro Oncologico-FIDES-La Plata, Buenos Aires, Argentina
| | - C Soares
- Ege University Medical Faculty, Izmir, Turkey; Gazi University Medical Faculty, Ankara, Turkey; King Abdulaziz Medical City National Guard Health Affairs, Riyadh, Saudi Arabia; King Abdullah Medical City - Oncology Centre, Jeddah, Saudi Arabia; Dicle University Medical Faculty, Diyarbakir, Turkey; Kartal Training and Research Hospital, Istanbul, Turkey; Marmara University Training and Research Hospital, Istanbul, Turkey; Gaziantep University Medical Faculty, Gaziantep, Turkey; King Fahad Specialist Hospital, Dammam, Saudi Arabia; Numune Training and Research Hosptial, Ankara, Turkey; Instituto Docente de Urología, Valencia, Venezuela; GlaxoSmithKline, Rio de Janeiro, Brazil; GlaxoSmithKline, Buenos Aires, Argentina; GlaxoSmithKline, Stockley Park, United Kingdom; Hospital Oncológico Padre Machado, Caracas, Venezuela; Centro Oncologico-FIDES-La Plata, Buenos Aires, Argentina
| | - S Landis
- Ege University Medical Faculty, Izmir, Turkey; Gazi University Medical Faculty, Ankara, Turkey; King Abdulaziz Medical City National Guard Health Affairs, Riyadh, Saudi Arabia; King Abdullah Medical City - Oncology Centre, Jeddah, Saudi Arabia; Dicle University Medical Faculty, Diyarbakir, Turkey; Kartal Training and Research Hospital, Istanbul, Turkey; Marmara University Training and Research Hospital, Istanbul, Turkey; Gaziantep University Medical Faculty, Gaziantep, Turkey; King Fahad Specialist Hospital, Dammam, Saudi Arabia; Numune Training and Research Hosptial, Ankara, Turkey; Instituto Docente de Urología, Valencia, Venezuela; GlaxoSmithKline, Rio de Janeiro, Brazil; GlaxoSmithKline, Buenos Aires, Argentina; GlaxoSmithKline, Stockley Park, United Kingdom; Hospital Oncológico Padre Machado, Caracas, Venezuela; Centro Oncologico-FIDES-La Plata, Buenos Aires, Argentina
| | - E Moraes
- Ege University Medical Faculty, Izmir, Turkey; Gazi University Medical Faculty, Ankara, Turkey; King Abdulaziz Medical City National Guard Health Affairs, Riyadh, Saudi Arabia; King Abdullah Medical City - Oncology Centre, Jeddah, Saudi Arabia; Dicle University Medical Faculty, Diyarbakir, Turkey; Kartal Training and Research Hospital, Istanbul, Turkey; Marmara University Training and Research Hospital, Istanbul, Turkey; Gaziantep University Medical Faculty, Gaziantep, Turkey; King Fahad Specialist Hospital, Dammam, Saudi Arabia; Numune Training and Research Hosptial, Ankara, Turkey; Instituto Docente de Urología, Valencia, Venezuela; GlaxoSmithKline, Rio de Janeiro, Brazil; GlaxoSmithKline, Buenos Aires, Argentina; GlaxoSmithKline, Stockley Park, United Kingdom; Hospital Oncológico Padre Machado, Caracas, Venezuela; Centro Oncologico-FIDES-La Plata, Buenos Aires, Argentina
| | - R Gidekel
- Ege University Medical Faculty, Izmir, Turkey; Gazi University Medical Faculty, Ankara, Turkey; King Abdulaziz Medical City National Guard Health Affairs, Riyadh, Saudi Arabia; King Abdullah Medical City - Oncology Centre, Jeddah, Saudi Arabia; Dicle University Medical Faculty, Diyarbakir, Turkey; Kartal Training and Research Hospital, Istanbul, Turkey; Marmara University Training and Research Hospital, Istanbul, Turkey; Gaziantep University Medical Faculty, Gaziantep, Turkey; King Fahad Specialist Hospital, Dammam, Saudi Arabia; Numune Training and Research Hosptial, Ankara, Turkey; Instituto Docente de Urología, Valencia, Venezuela; GlaxoSmithKline, Rio de Janeiro, Brazil; GlaxoSmithKline, Buenos Aires, Argentina; GlaxoSmithKline, Stockley Park, United Kingdom; Hospital Oncológico Padre Machado, Caracas, Venezuela; Centro Oncologico-FIDES-La Plata, Buenos Aires, Argentina
| | - S Santillana
- Ege University Medical Faculty, Izmir, Turkey; Gazi University Medical Faculty, Ankara, Turkey; King Abdulaziz Medical City National Guard Health Affairs, Riyadh, Saudi Arabia; King Abdullah Medical City - Oncology Centre, Jeddah, Saudi Arabia; Dicle University Medical Faculty, Diyarbakir, Turkey; Kartal Training and Research Hospital, Istanbul, Turkey; Marmara University Training and Research Hospital, Istanbul, Turkey; Gaziantep University Medical Faculty, Gaziantep, Turkey; King Fahad Specialist Hospital, Dammam, Saudi Arabia; Numune Training and Research Hosptial, Ankara, Turkey; Instituto Docente de Urología, Valencia, Venezuela; GlaxoSmithKline, Rio de Janeiro, Brazil; GlaxoSmithKline, Buenos Aires, Argentina; GlaxoSmithKline, Stockley Park, United Kingdom; Hospital Oncológico Padre Machado, Caracas, Venezuela; Centro Oncologico-FIDES-La Plata, Buenos Aires, Argentina
| | - P Nunez
- Ege University Medical Faculty, Izmir, Turkey; Gazi University Medical Faculty, Ankara, Turkey; King Abdulaziz Medical City National Guard Health Affairs, Riyadh, Saudi Arabia; King Abdullah Medical City - Oncology Centre, Jeddah, Saudi Arabia; Dicle University Medical Faculty, Diyarbakir, Turkey; Kartal Training and Research Hospital, Istanbul, Turkey; Marmara University Training and Research Hospital, Istanbul, Turkey; Gaziantep University Medical Faculty, Gaziantep, Turkey; King Fahad Specialist Hospital, Dammam, Saudi Arabia; Numune Training and Research Hosptial, Ankara, Turkey; Instituto Docente de Urología, Valencia, Venezuela; GlaxoSmithKline, Rio de Janeiro, Brazil; GlaxoSmithKline, Buenos Aires, Argentina; GlaxoSmithKline, Stockley Park, United Kingdom; Hospital Oncológico Padre Machado, Caracas, Venezuela; Centro Oncologico-FIDES-La Plata, Buenos Aires, Argentina
| | - S Cagnolati
- Ege University Medical Faculty, Izmir, Turkey; Gazi University Medical Faculty, Ankara, Turkey; King Abdulaziz Medical City National Guard Health Affairs, Riyadh, Saudi Arabia; King Abdullah Medical City - Oncology Centre, Jeddah, Saudi Arabia; Dicle University Medical Faculty, Diyarbakir, Turkey; Kartal Training and Research Hospital, Istanbul, Turkey; Marmara University Training and Research Hospital, Istanbul, Turkey; Gaziantep University Medical Faculty, Gaziantep, Turkey; King Fahad Specialist Hospital, Dammam, Saudi Arabia; Numune Training and Research Hosptial, Ankara, Turkey; Instituto Docente de Urología, Valencia, Venezuela; GlaxoSmithKline, Rio de Janeiro, Brazil; GlaxoSmithKline, Buenos Aires, Argentina; GlaxoSmithKline, Stockley Park, United Kingdom; Hospital Oncológico Padre Machado, Caracas, Venezuela; Centro Oncologico-FIDES-La Plata, Buenos Aires, Argentina
| | - JG Rodriguez
- Ege University Medical Faculty, Izmir, Turkey; Gazi University Medical Faculty, Ankara, Turkey; King Abdulaziz Medical City National Guard Health Affairs, Riyadh, Saudi Arabia; King Abdullah Medical City - Oncology Centre, Jeddah, Saudi Arabia; Dicle University Medical Faculty, Diyarbakir, Turkey; Kartal Training and Research Hospital, Istanbul, Turkey; Marmara University Training and Research Hospital, Istanbul, Turkey; Gaziantep University Medical Faculty, Gaziantep, Turkey; King Fahad Specialist Hospital, Dammam, Saudi Arabia; Numune Training and Research Hosptial, Ankara, Turkey; Instituto Docente de Urología, Valencia, Venezuela; GlaxoSmithKline, Rio de Janeiro, Brazil; GlaxoSmithKline, Buenos Aires, Argentina; GlaxoSmithKline, Stockley Park, United Kingdom; Hospital Oncológico Padre Machado, Caracas, Venezuela; Centro Oncologico-FIDES-La Plata, Buenos Aires, Argentina
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Leitão T, Rodrigues T, Soares C, Silva R, Garcia R, Martinho D, Romão A, Sandul A, Mendonça T, Pereira S, Varela J, Lopes T. UP-02.124 A Prospective Randomized Trial of Prostate Biopsy Protocols Comparing the Vienna Nomogram and a Standard 10-Core Biopsy Scheme. Urology 2011. [DOI: 10.1016/j.urology.2011.07.942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Soares C, Rodrigues P, Freitas-Silva O, Abrunhosa L, Venâncio A. HPLC method for simultaneous detection of aflatoxins and cyclopiazonic acid. WORLD MYCOTOXIN J 2010. [DOI: 10.3920/wmj2010.1216] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Aspergillus species in section Flavi are among the most relevant mycotoxigenic fungi. The organisms are well-known producers of the highly carcinogenic aflatoxins and of other mycotoxins, such as cyclopiazonic acid. Aflatoxins and cyclopiazonic acid analyses can be routinely used for identification purposes within the section. Two separate chromatographic runs with distinct columns and detectors for each toxin were required in previous reports. A straightforward high performance liquid chromatography (HPLC) procedure for the simultaneous detection of these compounds in fungal cultures was developed in the present work using a methanol/water mobile phase, postcolumn photochemical derivatisation and fluorescence detection. The proposed method was tested with standards and fungal extracts of 24 Aspergillus section Flavi strains and compared to the common individual detection of these mycotoxins by HPLC analyses.
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Affiliation(s)
- C. Soares
- Institute for Biotechnology and Bioengineering, Centre of Biological Engineering, University of Minho, Campus Gualtar, 4710-057, Braga, Portugal
| | - P. Rodrigues
- Institute for Biotechnology and Bioengineering, Centre of Biological Engineering, University of Minho, Campus Gualtar, 4710-057, Braga, Portugal
- CIMO, Escola Superior Agrária de Bragança, Campus Santa Apolónia, 5301-855 Bragança, Portugal
| | - O. Freitas-Silva
- Institute for Biotechnology and Bioengineering, Centre of Biological Engineering, University of Minho, Campus Gualtar, 4710-057, Braga, Portugal
- Embrapa Food Technology, Av. das Américas, 29501, 23.020-470, Rio de Janeiro, Brazil
| | - L. Abrunhosa
- Institute for Biotechnology and Bioengineering, Centre of Biological Engineering, University of Minho, Campus Gualtar, 4710-057, Braga, Portugal
| | - A. Venâncio
- Institute for Biotechnology and Bioengineering, Centre of Biological Engineering, University of Minho, Campus Gualtar, 4710-057, Braga, Portugal
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Cunha N, Madeira L, Melro A, Vianna G, Cipriano T, Soares C, Araujo A, Lacorte C, Aragão F, Rech E. Expression of functional recombinant proteins in transgenic soybean seeds. N Biotechnol 2009. [DOI: 10.1016/j.nbt.2009.06.678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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49
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Soares C, Minniti R, Massillon-JL G, Meek E, Walia J. TU-D-BRB-01: Comparison of the Response of EBT Emulsion to 90Sr/Y Beta Particles and 60Co Gamma Rays. Med Phys 2009. [DOI: 10.1118/1.3182367] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Massillon-JL G, Minniti R, Mitch M, Soares C. SU-FF-T-371: 3D Dose Distribution Around Two Low-Energy X-Ray Brachytherapy Seeds. Med Phys 2009. [DOI: 10.1118/1.3181852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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